Clinical Benefits of Tobacco Cessation for Cancer Patients
The extensive negative effects of tobacco use in relation to health have been well-documented in scientific literature and to a lesser extent in the media. Less well-known, however, are the specific risks to individuals already diagnosed with cancer.
There is growing literature on the direct and indirect effects of smoking and secondhand smoking on treatment effectiveness (short-term and long-term outcomes), toxicity, quality of life (QOL), return of the cancer or development of a second tumor and survival. Tobacco use by cancer patients can complicate a wide variety of treatments, including radiation therapy, chemotherapy and surgery (Gritz, Dresler & Sarna, 2005).
A cancer patient's tobacco use may have caused sufficient damage to the heart, lungs or other organs that the patient may not be able to withstand the optimal cancer care.
However, patients already diagnosed with cancer can still benefit greatly from cessation of their tobacco use. Not only will patients benefit from tobacco cessation, but physicians will have fewer complications when implementing various cancer treatments, possibly saving valuable time and resources and improving outcomes of clinical trials.
Some of the benefits of quitting tobacco use and negative effects of continued use on a cancer patient's treatment and quality of life are listed below.

Improved Surgical Recovery
• Wound healing (Frick et al., 1994)
• Reduced pulmonary, circulatory and infectious complications (Bluman et al., 1998; Morton et al., 1994)
• Reduced post-operative admittance to Intensive Care Unit (ICU) (Moller et al., 2001)

Improved Quality of Life Scores
• Persistent cigarette smoking after lung cancer diagnosis negatively affects quality of life (Garces et al., 2004)
Risks of Continued Smoking in Patients Treated with Radiotherapy
• Lower response rates, poorer survival and exacerbated side effects (Browman et al., 1993)
• Difficulty regaining satisfactory voice quality (Karim et al., 1983)
• Higher risk for developing second malignant tumors (Hiyama et al., 1992)

Risk of Continued Smoking in Patients Treated with Chemotherapy
• Long-term pulmonary toxicity (Lehne et al., 1993)
• Suppression of immune function (Tollerud et al., 1989)

Quitting Today
If a patient stops smoking today, his or her risk of:
• Stroke is reduced to that of a non-smoker after five to 15 years
• Cancer of the mouth, throat, and esophagus is reduced by 50% after five years compared to continuing smokers
• Cancer of the larynx is reduced compared to continuing smokers
• Coronary heart disease is reduced by 50% one year after quitting compared to a smoker; risk returns to that of a nonsmoker after 15 years

• Chronic obstructive pulmonary disease is reduced compared to continuing smokers
• Lung cancer is reduced by 50% after 10 years compared to continuing smokers
• Pancreatic cancer is reduced after 10 years compared to continuing smokers
• Ulcers are reduced
• Bladder cancer is reduced by 50% a few years after quitting
• Peripheral artery disease is reduced compared to continuing smokers
• Cervical cancer is reduced in a few years compared to continuing smokers
• Low-birthweight babies are reduced to that of a nonsmoker in women who quit before pregnancy or during the first trimester

[DHHS Publication No. (CDC) 90-8419]
The Tobacco Treatment Program would like to express gratitude to Dr. Joel Dunnington for his assistance with the development of this information.

Time Period	Other General Benefits of Smoking Cessation
2 weeks	Heart rate, pulse, and blood pressure begin to return to normal Body temperature of the hands 0and feet begins to increase to normal Carbon monoxide and oxygen levels begin to return to normal Your circulation begins to improve Sense of smell and taste begin to improve Allergy flare-ups decrease Excess mucous and phlegm production decreases Breathing begins to feel easier
3 months	Cosmetic benefits (healthier, brighter skin) are often seen Lung function improves, decreased coughing, reduced sinus infection, less fatigue and less shortness of breath You will have saved at least $460* by this time
1 year	Coronary Heart Disease (CHD): excess risk is reduced by 50 percent among ex-smokers Allergy flare-ups decrease Excess mucous and phlegm production decreases If pregnant, your chances of having a healthy baby increases You will have saved approximately $1,825* by this time
5 years	Stroke risk returns to levels equal to people who have never smoked You will have saved $9,125*
10 years	The risk of lung cancer is 30-50 percent that of average smokers. Beyond 10 years, smoking cessation reduces the risk of cancers of the larynx, oral cavity, esophagus, pancreas, urinary bladder and gastrointestinal ulcers. CHD risk will equal that of persons who have never smoked You will have saved approximately $18,250*

* Based on approximately $9.00/day for 1 pack of cigarettes

References:

Fiore. M.C., Jaén C.R.., Baker, T.B., et al. (2008) Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services Public Health Service

Centers for Disease Control (CDC). (2004) Surgeon General’s Report: The health consequences of smoking on the human body. Retrieved from http://www.cdc.gov/tobacco/sgr/sgr_2004/sgranimation/flash/index.html.

Centers for Disease Control (CDC). (1990) The surgeon general’s 1990 report on the health benefits of smoking cessation executive summary: Preface. MMWR 39:viii-xv.