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Stopping smoking after a cancer diagnosis improves survival, reduces treatment complications and second cancers, and is the single most effective supportive intervention that oncology services still routinely fail to deliver.
Continued smoking after diagnosis increases all-cause and cancer-specific mortality (2014 Surgeon General's report: about 50% higher risk of death in lung and head and neck cancer), impairs wound healing and radiotherapy response, increases chemotherapy toxicity and treatment interruptions, and raises the risk of second primary cancers. Quitting within months of diagnosis of early lung cancer improves survival by around a third in cohort studies and a randomised trial of intensive cessation support in the ELCAP and Moscow cohorts (Annals of Internal Medicine 2021) showed better survival. Evidence-based treatment is varenicline or cytisine plus behavioural support, which doubles or triples quit rates. Despite this, fewer than half of cancer centres systematically assess and treat tobacco use; the NCI Cancer Center Cessation Initiative (C3I) and the UK's opt-out 'Cure' model demonstrate that embedding cessation into oncology pathways lifts treatment rates from single digits to over 50%.
Removing ongoing carcinogen exposure and hypoxia-inducing carboxyhaemoglobin improves radiotherapy oxygen enhancement and drug metabolism, halts field cancerisation, and lowers cardiovascular competing risk.
One technology page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
The single most quotable number in tobacco control: quitting at 30 avoids almost all the risk, quitting at 50 avoids half of it, and it is never not worth stopping. It is also the argument for putting cessation support inside a lung screening appointment rather than beside it.
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Shares Hypopharyngeal cancer, Laryngeal and hypopharyngeal cancer, Oral tongue and floor of mouth cancer, Oesophageal squamous cell carcinoma.
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Shares Stopping smoking, Oropharyngeal cancer (tonsil and base of tongue), Low-dose CT lung screening, Prevention we already have is not deployed.
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Shares Tobacco 21, Family Smoking Prevention and Tobacco Control Act 2009, Prevention we already have is not deployed, Oesophageal cancer.
Shares Hypopharyngeal cancer, Laryngeal and hypopharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer).
Shares Lip cancer, Laryngeal and hypopharyngeal cancer, Oral tongue and floor of mouth cancer, Oropharyngeal cancer (tonsil and base of tongue).