Patrick J. Skerrett

Smokers with cancer benefit from quitting, but need extra help

There are many reasons to quit smoking. Being diagnosed with cancer can be a powerful one. But many people have trouble quitting even after learning they have cancer.

A team from Harvard-affiliated Massachusetts General Hospital (MGH) analyzed data from 1,400 smokers newly diagnosed with lung or colorectal cancer. Five months after learning they had cancer, just over one-third (37%) of those with lung cancer and two-thirds (66%) of those with colorectal cancer were still smoking. The results are published online today in the medical journal Cancer.

To be fair, the quit rates in the MGH study are much higher than seen in most studies of quitters. On average, only about 6% of people who stop smoking are still off cigarettes six months later.

Demon nicotine

“Our results underscore just how difficult it can be to quit smoking,” lead researcher Dr. Elyse R. Park told me. “A diagnosis of cancer can certainly be a powerful motivator, but it isn’t always enough—people need help to quit,” said Park, who is an associate professor of psychiatry at Harvard Medical School and director of behavioral sciences for the MGH Tobacco Research and Treatment Center.

Each hit of nicotine activates the brain’s reward and motivation center, producing pleasurable feelings. But as nicotine gets washed out of the body, the feelings of pleasure are replaced by uncomfortable symptoms of withdrawal—trouble concentrating, nervousness, headache, dizziness, irritability, anxiety, increased appetite, depression, and sleeping problems. This prompts users to reach for a cigarette. Research has shown that nicotine is at least as addictive as cocaine and heroin.

Kicking a smoking habit is good for health anytime. It is even more important after a diagnosis of cancer. Continuing to smoke can lessen the effectiveness of cancer treatment and slow recovery after surgery. Smokers who quit may live longer after being diagnosed with cancer than those who don’t.

But smokers diagnosed with cancer don’t always get the help they need, even from their doctors. Few clinicians address the issue of smoking with their patients, and most don’t know how to do it, writes Carolyn R. Dresler, the Tobacco Control Branch Chief for the state of Arkansas, in an editorial accompanying the paper.

Getting over the barriers

Quitting smoking isn’t merely a matter of willpower. It takes effort on two fronts—breaking the physical addiction to nicotine and breaking the psychological or behavioral habits associated with smoking.

Medications can help with the physical addiction. Nicotine delivered via gum, patch, lozenge, or inhaler can replace the nicotine from cigarettes without the tar, carbon monoxide, and dozens of other toxic ingredients in smoke. Two prescription medications—bupropion (Wellbutrin, Zyban) and varenicline (Chantix)—can also help cut the craving to smoke.

The psychosocial aspects of quitting can be challenging. The stigma associated with smoking, for example, can work against quitting. “People with cancer may feel embarrassed or guilty about continuing to smoke, and try to hide it,” says Dr. Mary E. Cooley, a nurse-scientist at Harvard-affiliated Dana Farber Cancer Institute whose work focuses on smoking cessation among people with cancer. Smokers also often live with one or more smokers, which makes quitting difficult.

As is true for all smokers, it may take a while to decide to stop smoking and take the necessary steps. And it often takes several attempts to quit before one is successful.

“It’s a complicated issue,” says study leader Park. “But with help and support from family members, friends, and physicians, cancer patients can successfully quit smoking and improve their health and chances of survival.”

Excellent free information about quitting smoking is available from Smokefree.gov, a website developed by the National Cancer Institute.

Comments:

  1. ruth

    i am trying to give up smoking and need to know if e cigs are safe i read a post which says they contain a chemical which is found in antifreeze?

  2. namasaya

    good job for having written this article

  3. Alvaro

    there are many women in the world who suffer from the problem of snuff, but quit smoking is easier when you propose and execute a method to exactly

    • Dhayat

      There is a slim chance of you itntgeg accepted into Harvard. You are not going to get a full scholarship to Harvard, or any college here.There is very little in the way of financial aid or scholarships here for international student students.You can go on any college web site to see what their requirements are.

  4. `Thomas

    Smoking is more dangerous than alcoholism. But the younger generation feel that the smoking make one greater than others. and a social greatness.The blunder foolishness . Lt us hope for a smoke free healthy generation

  5. Brad Major

    I stop smoking after being diagnosed with kidney cancer 4 years ago.

    Now that I have been smoke free for 4 years I feel much better.

  6. Vijay Vaishnav

    Not many people know that those who sport moustaches and smoke are at a greater risk because the smoke as well as the other compounds (read toxins) released are adsorbed onto the bushes on the upper lip.
    It is only after the effects of tobacco on the body have reached a stage where the person develops chronic gastritis or cancer or vascular disease that he thinks of quitting the habit.
    alternative therapies can sometimes have surprising results in removing the craving for tobacco.

  7. Anonymous

    i want to leave smoking at any cost please help me………..

  8. markz111

    I totally agree with your findings although I used to drink milk every single day:)) thank u for all your excerted efforts to reveal truths about nutrition because we live in a world so greedy for money undermining totally human health and how severely it’s gets affected.

  9. John R. Polito

    An excellent article, PJ, until you get to the part where you suggest that real-world use of NRT, Zyban and Chantix is superior to quitting without them. While each clobbers placebo inside randomized clinical trials, they have failed to prevail over: (1) unassisted quitters, (2) non-medication quitters and (3) cold turkey quitters, in almost all long-term (>6 months) population level studies since 2000, including the only official government quitting method survey, the National Cancer Institute’s 2006 Hartman study. We don’t know why, but both the CDC and NCI continue to hide real-world findings while behaving as though pharm industry employees.

    Your article also recommends http://www.SmokeFree.gov, where by last count smokers are bombarded with 173 invitations to purchase and use “medication” or “medicine.” But SmokeFree.gov’s most destructive lesson is that its “slip” page teaches smokers that lapse is easily and normally overcome, when in truth lapse is almost always followed by relapse (80-95%).

    Although addiction to smoking nicotine is as real and permanent as alcoholism, there is only one lesson that all quitters need follow in order to keep their chemical dependency arrested for the balance of life. It’s that one equals all, that lapse equals relapse, that one puff is too many and thousands never enough. There’s just one rule .. no nicotine just one day at a time, to never take another puff! Yes you can!!!

  10. Joe Smyser

    This is sad news, offering further insight into just how addictive smoking can be. Perhaps another angle to consider for anti-smoking programs/materials would be to share just how toxic cigarette butts are, even when disposed of properly. The science behind this research can be found at http://www.toxicbutts.com