Treating nicotine dependence and preventing smoking relapse in cancer patients

ABSTRACT

Introduction: Despite the well-documented harmful effects of smoking, many cancer patients continue to smoke. Smoking cessation is critical to address in this population given the associated increase in treatment toxicity, risk of second primary tumors, decrease in treatment response and higher disease-specific and all-cause mortality with continued smoking following a cancer diagnosis. This review seeks to summarize the latest recommendations and guidelines on smoking cessation treatment for patients diagnosed with cancer, and the evidence behind those recommendations.

Areas covered: We reviewed the latest evidence for smoking cessation treatments for cancer patients and the clinical guidelines and recommendation available for oncologists and health care providers. The unique aspects of nicotine dependence among patients diagnosed with cancer, and key challenges and barriers that cancer survivors and health care providers experience when considering smoking cessation treatments, and available clinical resources, are also discussed. Lastly, the authors summarize future directions in the field of smoking cessation treatment for cancer patients.

Expert commentary: While there are areas of improvement in research of smoking cessation treatment for cancer patients, critical under-explored areas remain. Nonetheless, providers should adhere to the NCCN guidelines and offer a brief counseling intervention to motivate patients to quit smoking when appropriate resources are not available.

KEYWORDS:

• Nicotine dependence
• cancer
• cancer survivors
• oncology
• tobacco
• smoking
• cessation
• treatment
• intervention

Declaration of interest

B Hitsman receives varenicline and placebo free of charge from Pfizer for use in an ongoing NIH sponsored clinical trial. B Hitsman has served on a scientific advisory board for pfizer. R Schnoll receives medication and placebo free of charge from Pfizer and has provided consultation to Pfizer. R Schnoll has also consulted for GlaxoSmithKline. These companies had no involvement in this work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

Support for this manuscript was provided by National Cancer Institute grants R01 CA184211 and R01 CA165001.