Lung Cancer Patients Who Stop Smoking Live Longer

Clinical interventions help patients with smoking cessation, extending survival

BUFFALO, N.Y. — Tobacco cessation provided significant survival benefit for lung cancer patients who quit smoking shortly before or after diagnosis, despite the severity of the disease. Results of the Roswell Park Cancer Institute study were published in the Journal of Thoracic Oncology.

Roswell Park has a unique Tobacco Assessment and Cessation Service (TACS) that conducts a standardized tobacco use assessment for lung cancer patients treated in the Thoracic Center, and automatically refers patients who smoke to a dedicated tobacco cessation counseling service. Using data from TACS, 250 patients participated in the study.  Those who had recently stopped smoking (50), or quit after their first contact with TACS (71) had reduced mortality rates compared to patients who continued to use tobacco. The median survival for patients who reported they had stopped smoking was 28 months compared with 18 months for those who continued to use tobacco. The survival advantage for those who stopped smoking was adjusted for demographics, disease stage and other health characteristics.

“To our knowledge, this is one of the first studies to examine the impact of tobacco cessation on survival among lung cancer patients who participated in a mandatory assessment and automatic referral to a tobacco cessation service,” says senior author Mary Reid, MSPH, PhD, Director of Cancer Screening and Survivorship at Roswell Park.

Results also suggested that there may be a survival benefit even if a patient has not completely quit tobacco use, but continues to attempt to quit after a cancer diagnosis. Mortality rates for those who relapsed were similar to current users.

Tobacco use among lung cancer patients is rarely collected in a standardized, prospective manner that can be used for clinical outcomes research, according to Dr. Reid. However, TACS collects standardized tobacco use information at diagnosis and follow-up. The researchers recommended that given the impact of smoking cessation on improved cancer survival, structured smoking assessments administered at regular intervals should be included as standard of care in clinical practice and clinical trials.

“Establishing services to accurately screen for tobacco use and easily accessible cessation programs are essential in the cancer care setting to further improve the survival time and quality of life of patients,” Dr. Reid adds.

The study title is: “Tobacco Cessation Improves Lung Cancer Patient Survival.” Conflicts of Interest and Source of Funding: Dr. Cummings has a grant from Pfizer for testing an inpatient hospital tobacco cessation service. In addition, Drs. Cummings and Mahoney both serve as expert witnesses for the plaintiffs in tobacco litigation cases. The other authors have no conflicts of interest to report. This work was supported, in part, by the Roswell Park Alliance Foundation, National Cancer Institute grant R25CA113951 and the American Cancer Society (GWW, MRSG 11-031001-CCE).