Smoking among lung cancer patients

Tobacco use among patients with cancer is a se-
rious health problem with significant implications
for morbidity and mortality [36–39]. Evidence in-
dicates that continued smoking after a diagnosis
with cancer has substantial adverse effects on treat-
ment effectiveness [40], overall survival [41], risk
of second primary malignancy [42], and increases
the rate and severity of treatment-related complica-
tions such as pulmonary and circulatory problems,
infections, impaired would healing, mucositis, and
Xerostomia [43,44].
Despite the strong evidence for the role of smok-
ing in the development of cancer, many cancer pa-
tients continue to smoke. Specifically, about one
third of cancer patients who smoked prior to their
diagnoses continue to smoke [45] and among pa-
tients received surgical treatment of stage I nonsmall
cell lung cancer [46] found only 40%who were ab-
stinent 2 years after surgery. Davison and Duffy [47]
reported that 48% of former smokers had resumed
regular smoking after surgical treatment of lung
cancer. Therefore, among patients with smoking-
related malignancies, the likelihood of a positive
smoking history at and after diagnosis is high.
Patients who are diagnosed with lung cancermay
face tremendous challenges and motivation to quit
after a cancer diagnosis can be influenced by a range
of psychological variables. Schnoll and colleagues
[48] reported that continued smoking among pa-
tients with head and neck and lung cancer is asso-
ciated with lesser readiness to quit, having relatives
who smoke at home, greater time between diag-
noses and assessment, greater nicotine dependence,
lower self-efficacy, lower risk perception, fewer per-
ceived pros and greater cons to quitting, more fa-
talistic beliefs, and higher emotional distress. Lung
cancer patients should be advised to quit smoking,
but once they are diagnosed, some might feel that
there is nothing to be gained from quitting [49].
Smoking cessation should be a matter of special
concern throughout cancer diagnosis, treatment,
and the survival continuum, and the diagnosis of
cancer should be used as a “teachable moment”
to encourage smoking cessation among patients,
family members, and significant others [37]. The