Smoking is the major risk factor for several types of cancers and is responsible for 35% all cancer types and for 80% of head-neck and lung cancers. Persistent smoking in the cancer patients reduces the effectiveness of chemo and/or radio treatments, increases perioperative risks, the toxicity associated with cancer treatments, increases the risk of recurrence, and reduces survival time. Despite all these known negative effects, a high percentage of cancer patients who smoked at the time of diagnosis do not quit when diagnosed or during their treatment. Rates differ from type of cancer and geographic area, but 25% to 34% of cancer patients who smoked before the diagnosis continue to do so afterwards. Cancer patients who continue to smoke after diagnosis show higher rates of nicotine dependence, low self-efficacy, higher levels of depression and/or anxiety. Nevertheless, smoking cessation after cancer diagnosis is associated with better clinical outcomes.
Thus, developing tobacco cessation interventions is a key tertiary prevention strategy that could improve cancer patients’ health conditions. However, smoking cessation interventions are not well spread among cancer health care services. Only 40-60% of cancer patients who smoke report having been told to quit by their health providers, demonstrating the low level of assistance of oncology providers in providing support to quit. As a result, cancer patients are not receiving the necessary support to quit in a relevant and “teachable moment”. There is a need to design interventions that could help patients recognize their specific risks of smoking during and after cancer treatment. Specific strategies to promote cessation among cancer patients include: to train health providers in smoking cessation, to identify mechanisms to integrate cessation into cancer treatment programs and, to develop methods to improve tobacco cessation efficacy among these patients.