ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد ایتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Treatment of alcohol use and smoking for cancer survivors

Treatment of alcohol use and smoking for cancer survivors
Authors:
Maher Karam-Hage, MD
Jennifer Minnix, PhD
Paul M Cinciripini, PhD
Section Editor:
Patricia A Ganz, MD
Deputy Editor:
Sonali Shah, MD
Literature review current through: Jun 2022. | This topic last updated: May 06, 2022.

INTRODUCTION — The number of living cancer survivors is expected to rise within the United States [1]. Compared with population growth, these increases have been attributed mostly to improved diagnostic modalities resulting in early detection of cancer and to the development of more effective and less toxic treatments. This increase in survival rates highlights the importance of caring for cancer survivors.

While smoking rates have continuously decreased over several decades, the overall smoking prevalence in the United States had remained nearly constant for several years, with some decline in the past few years to approximately 14 percent [2,3]. Despite these trends, approximately 50 million and 41 million Americans still use any forms of tobacco or smoke cigarettes, respectively, despite widespread knowledge that smoking and tobacco use causes cancer as well as cardiovascular disease, pulmonary disease, and several other deadly diseases [4]. Cancer patients and survivors who have comorbid psychiatric disorders are also more likely to be addicted to nicotine and face more difficulty quitting similarly to patients without cancer [5,6]; therefore, innovative methods are needed to effectively reduce the impact of such disorders [7].

The carcinogenic effects of both alcohol and tobacco have been scientifically established. However, although many alcohol users are informed about organ damage caused by alcohol and the dangers and the legal and social consequences of being intoxicated, far fewer recognize the significant cancer risk of heavy alcohol use [8]. In one review, public awareness of the link between alcohol and cancer was known to approximately 25 and 40 percent of the population [9].

This review discusses the impact on quitting alcohol and smoking in cancer survivors who have completed cancer-directed treatment. Further discussion on alcohol and tobacco in the general population is covered separately. (See "Cigarette smoking and other possible risk factors for lung cancer" and "Benefits and consequences of smoking cessation" and "Overview of cancer prevention", section on 'Tobacco use' and "Overview of the risks and benefits of alcohol consumption".)

EPIDEMIOLOGY

Tobacco use — Data suggest that smoking and tobacco use continues to be an issue for cancer survivors, especially among adolescent and young adult (AYA) cancer survivors. The prevalence of smoking and tobacco use differs by patient age, time from diagnosis, type of cancer, cancer prognosis, and treatment received [10].

Data on the prevalence of tobacco use among cancer survivors come from the annual population-based National Health Interview Survey (NIHS). While prevalence has declined, approximately 13 percent of cancer survivors aged 18 and older were current cigarette smokers in 2019; in addition, the prevalence of tobacco use appears to be higher among AYA cancer survivors [11]. The following is a subset of findings that have been reported based on data from NIHS:

In an analysis from 2005, almost 20 percent of adult cancer survivors reported being current smokers, with 43 percent of cancer survivors younger than 40 years reporting current smoking [12].

In a subsequent analysis (2012 to 2014 NIHS), 33 percent of AYA cancer survivors were smokers compared with 22 percent of adult cancer survivors [13].

Smoking among cancer survivors who are 18 years of age or older declined almost by half over 25 years (from 20 percent for cohort 1998 to 2001 to approximately 14 percent in cohort 2013 to 2017) [14].

Compared with individuals without a cancer history overall, a lower percentage of those with a cancer history were never-smokers (48 versus 62 percent) or current smokers (14 versus 17 percent).

The prevalence of current smoking was higher among survivors of smoking-related cancers (around 20 percent) compared with nonsmoking-related cancer survivors (around 10 percent). After cancer diagnosis, smoking-related cancer survivors had higher odds of continued smoking compared with nonsmoking-related cancer survivors (odds ratio [OR], 2.1; 95% CI, 1.12-3.93) [15].

Although the prevalence of smoking is high among patients with smoking-related cancers at diagnosis, cancer treatment and prognosis may have an influence on lowering the rate of smoking among patients who survive such cancers [16-19]. For example, smoking prevalence is 40 to 60 percent at time of diagnosis among patients with lung or head and neck tumors [16,18,20,21], and approximately 40 percent among patients with any smoking-related cancer (other than lung cancer) [22]. Patients with a cancer site that is clearly attributable to smoking and a favorable prognosis may be more motivated to quit than those with a poor prognosis [23]; however, the benefits of abstinence from smoking are present regardless of prognosis or stage [24]. In addition, the nature of the cancer treatment required affects the ability to smoke; for example, cancer patients who are hospitalized or undergo surgery will be forced to quit smoking, at least for a short time.

Alcohol consumption — Heavy alcohol use raises the risk of developing cancer in several different sites, including the head and neck, esophagus, colon and rectum, liver, and breast (in females). (See "Overview of the risks and benefits of alcohol consumption", section on 'Cancer'.)

Multiple studies show that despite a cancer diagnosis, many cancer survivors continue to consume alcohol. As examples:

Of over 10,000 respondents who were a part of the British Childhood Cancer Survivor study, the proportion who [25]:

Admitted to drinking alcohol – 77 percent

Drank above weekly recommendations – 24 percent

Consumed potentially harmful amounts – 4 percent

Another study compared the frequency of alcohol use among almost 1050 young adult cancer survivors with figures from a representative general population survey [26]. Compared with controls, survivors were almost:

Two times more likely to consume alcohol frequently (odds ratio [OR] 1.7, 95% CI 1.3-2.1)

Three times more likely to binge drink (OR 2.9, 95% CI 2.3-3.8)

In addition, studies show that advanced cancer patients have a high prevalence of alcohol use. For example, one study concluded that the prevalence of current alcohol use in cancer patients was 18 percent [27]. A separate study that included over 280 patients with head and neck cancer reported that 45 percent of these patients continued to consume alcohol 12 months after diagnosis, with over 20 percent of those who continued to drink classified as problem drinkers [28].

Impact of smoking on outcomes after cancer diagnosis — Although most data come from retrospective studies, smoking appears to have a deleterious impact on cancer treatment [29]. The 2014 Surgeon General's report concluded that a causal relationship exists between smoking at diagnosis and both all-cause and cancer-specific mortality, as well as increased risk of disease progression and tobacco-related second primary cancers. The evidence reviewed strongly suggests that continued smoking increases the risk of cancer recurrence, poor treatment response, and treatment-related toxicities [29,30]. On the other hand, quitting smoking even at the time of diagnosis reduces the risk of dying by approximately 30 to 40 percent [30,31], improves physiological and psychological functioning [32-34], and has benefits that may equal and may even exceed those of the best cancer treatments available [35].

Several studies have demonstrated the harmful effect of continued smoking on cancer treatment in cancers of the head and neck [36-43], oropharynx [44], lung [45,46], prostate [47,48], and breast [49]. As an example, one study reported that cancer patients who were smokers had a significantly higher symptom burden than nonsmokers, both during and six months following treatment [50]. As another example, relapse rates in lung or head and neck cancer patients 12 months after surgery were markedly higher in patients who were still smoking the week before surgery (60 percent) versus those who were abstinent during the week before surgery (13 percent) [51]. Finally, in another study, patients with prostate cancer (which is not a known smoking-related cancer) who continued to smoke during treatment were at an increased risk for toxicity, recurrence, metastasis, and mortality compared with nonsmokers [47].

The effect of continuing to smoke for cancer survivors is similarly harmful:

In one review that included 10 studies, people who continued to smoke after a diagnosis of early-stage lung cancer almost doubled their risk of dying [52].

In another study that included 611 patients with small cell lung cancer, the risk of all second cancers (mostly non-small cell cancers of the lung) was increased by 3.5 times in smokers (relative risk [RR] 3.5, 95% CI 2.8-4.3) [53]. Compared with never-smokers, the risk of a second lung cancer among patients who received chest radiation was significantly increased (RR 13, 95% CI 9.4-17).

In addition, several studies show that cancer survivors who were former smokers/recent quitters or current smokers scored lower on quality of life indices and had worse health and social functioning than survivors who had never smoked [45,54-56].

Smoking prior to a diagnosis of cancer is also associated with an increased risk of subsequent (second) cancer risk among cancer survivors. An analysis of five cohort studies of cancer (stage I lung, bladder, kidney, and head and neck) survivors who were current smokers prior to the diagnosis of their first cancer diagnosis found a 3 to 8 percent increase in five-year cumulative risks of subsequent smoking-associated cancers, compared with never-smokers [57]. (See "Overview of cancer survivorship care for primary care and oncology providers", section on 'Risk of subsequent primary cancer'.)

Impact of alcohol on outcomes after cancer diagnosis — Data also suggest that alcohol intake (especially moderate to heavy use) increases cancer-related mortality. This was shown in a 2013 meta-analysis that concluded all-cancer mortality was highest in participants who regularly consumed 50 or more grams of alcohol [58]. Curiously, this report also had the following observations:

There is a J-shaped curve for all-cancer mortality; patients who drank <12.5 grams of alcohol per day had the lowest mortality.

The mortality associated with alcohol was predominantly in males. Males who consumed up to 12.8 grams of ethanol daily had the lowest mortality rate. However, those who drank ≥28.7 grams per day had a statistically significant increase in their cancer mortality rate.

For females, consumption of up to 9.1 grams of alcohol daily was associated with the lowest cancer mortality. The increased risk of breast cancer and risk of mortality became significant at 17.4 grams per day and reached a peak at 43.6 grams daily. Interestingly, in the female study population, 75.9 grams or more of daily ethanol intake was associated with less all-cancer mortality, most likely owing to the fact that if a female were to consume such large amounts, her chances of non-cancer mortality were increased significantly when compared with those who did not consume or consumed lower amounts of alcohol.

A subsequent study showed that overall mortality from cancer and other diseases was five times higher in Italian patients who are alcohol-dependent than in Italian patients who did not drink alcohol [59]. This study concluded that being female was a protective factor, as females outlived males at the 5, 10, 15, and 20-year follow-up analyses.

EVALUATION — It is imperative for clinicians working with cancer survivors to systematically screen those survivors for smoking and alcohol use [60,61]. Cancer survivors should be screened for use and dependence (ie, use disorder) using a similar approach to those without a history of cancer, in the absence of a specific diagnostic evaluation tailored for cancer survivors. (See "Clinical assessment of substance use disorders" and "Risky drinking and alcohol use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis", section on 'Screening'.)

Lung cancer screening — The United States Preventive Services Task Force (USPSTF) and other expert groups recommend screening for lung cancer using annual low-dose computed tomography (LDCT) in adults at high risk for lung cancer. The indications for lung cancer screening in cancer survivors is the same as that used for the general population, which are discussed separately. (See "Screening for lung cancer", section on 'Recommendations by expert groups'.)

Cancer survivors with a smoking history may be candidates for lung cancer screening with LDCT of the chest, which is associated with decreased lung cancer mortality and all-cause mortality in the general population [62]. Further studies on lung cancer screening specifically in cancer survivors are needed to understand the unique characteristics of this population, as well as the context within which treatment should be provided [63].

Screening and co-occurring conditions — To treat a substance use disorder, clinicians must be aware of its presence and be able to make the diagnosis and then offer advice to quit or refer to treatment [64]. While there are no specific demographics, smoking and tobacco use among cancer survivors would be expected to be more frequent in certain populations than in others, as in the general population, including those with [65,66]:

Low educational attainment – Up to 35 percent of those with less than a high school degree and 45 percent of those with only a GED are smokers. Binge drinking is higher among college graduates, up to 14 percent, in the past 30 days.

Low socioeconomic status – Around 40 percent of those under the federal poverty level are tobacco users, and around 30 percent report smoking in the past 30 days.

Psychiatric disorders – Several studies have reported a correlation between smoking and/or excessive alcohol use with psychiatric disorders within the general population [67-77]. As an example, in one observational study of cancer patients, while higher levels of pre-quitting anxiety and fear of recurrence predicted smoking cessation, higher levels of depressive symptoms significantly predicted relapse [78]. In another observational study of cancer survivors, quitting smoking was associated with a decreased fear of disease recurrence [79]. In contrast, among cancer survivors who continue to smoke, fear of recurrence was associated with impaired function and mood. This may explain the propensity of cancer survivors to develop an addiction to substances and having more difficulty quitting [80]. Additionally, the impact of psychiatric comorbidities would be expected to be similarly important among cancer survivors.

TREATMENT APPROACHES — There are limited data on interventions specific to cancer survivors, particularly for issues related to stopping or decreasing smoking and alcohol use. In general, the treatment approaches are similar to those of the general population.

Treatment of smoking — The approach to helping cancer survivors quit smoking is similar to that of the general population. The Centers for Disease Control and Prevention (CDC) has a dedicated page and resources on the topic for health care professionals [81]. The National Comprehensive Cancer Network (NCCN) has dedicated guidelines for smoking cessation in the oncology setting [82]. An overview of the treatment (including pharmacotherapy) for smoking in adults is discussed in detail separately. (See "Overview of smoking cessation management in adults" and "Pharmacotherapy for smoking cessation in adults".)

While little is known about the naturalistic factors that may interfere with cancer patients' and cancer survivors' efforts and ability to quit smoking [83], evidence suggests that they stand to benefit immensely from comprehensive treatment efforts that lead to tobacco abstinence that are also used in patients without cancer. Such efforts include individualized counseling, pharmacotherapy [84,85], and treatment of psychiatric disorders and other psychosocial stressors.

Only a few well-designed prospective studies on the treatment of smoking have focused on cancer patients and survivors, with approximately half concentrating on nurse-delivered interventions [86]. As examples:

One meta-analysis reported that providing a smoking treatment intervention to cancer patients in general did not improve overall abstinence rates, although it was clear that heavy smokers and those in the perioperative period did benefit from this type of intervention [87]. This mixed finding may be due to lack of homogeneity among the pooled studies, as the studies had different treatment intensities, had different measures for smoking and abstinence, and included different cancer sites and cancer patient populations (outpatients only or inpatients only).

Another report described smoking outcomes from over 3000 smokers (including cancer patients, cancer survivors, and smokers with no cancer history) enrolled in a comprehensive tobacco cessation clinical program [88]. The program included individualized cessation counseling, provision of personalized pharmacotherapy, and integrated assessment and treatment of mental health conditions and other psychosocial stressors [88]. This study reported average abstinence rates of 45, 46, and 44 percent, at the three-, six-, and nine-month follow-ups, respectively. Importantly, these rates did not significantly differ between cancer and non-cancer patients, and only head and neck cancer patients achieved statistically higher abstinence rates.

Treatment for alcohol use — The treatment for alcohol use requires both psychosocial support and pharmacological interventions. (See "Alcohol use disorder: Psychosocial treatment" and "Brief intervention for unhealthy alcohol and other drug use: Efficacy, adverse effects, and administration".)

Although stopping smoking and total abstinence is recommended unequivocally, whether there is a "safe" amount of alcohol one can consume is controversial. In the United States, the CDC and the United States Department of Health and Health Services (HHS) suggest that a limit of two drinks per day (13.7 grams per drink) for males and one drink per day for females is "sensible" or "low-risk" drinking [89].

However, this recommendation is based on studies that evaluate the short-term effects of alcohol use (eg, social or psychological problems or hospital admissions) and may not account for all the risks and consequences of chronic, long-term exposure. Therefore, many critics have pointed to the limitations of such "sensible drinking" guidelines. It should also be noted that these guidelines do not apply to all subsets of a population. For example, pregnant patients, children, older adults, or those who operate machinery cannot use the "sensible drinking" guidelines to determine whether their level of alcohol consumption is safe.

Cancer survivors ought to be thought of as "a population at risk"; unfortunately, the public perception about the link between alcohol and cancer is low [9]. The American Institute for Cancer Research recommends "not drinking alcohol" for cancer prevention. The American Society of Clinical Oncology (ASCO) published a statement on the importance and the need for cancer treatment providers to educate their patients about the link between alcohol and cancer [90]. While education about the risk is not equivalent to providing treatment, it is a necessary first step. Education can then be followed by screening and referral for those who need treatment.

Treating comorbid psychiatric disorders — For some patients, treatment of comorbid psychiatric disorders may aid in their ability to quit smoking and reduce alcohol intake. Treating such conditions may increase resilience, improve the patient's ability to face cancer, and strengthen their ability to maintain abstinence after quitting tobacco [91] or further limiting (or stopping) alcohol intake. As reported in one study, patients with low depression scores and patients with early tumor stages were more confident about their ability to quit smoking than were those with higher depression scores and those with more advanced tumor stages [23]. (See "Overview of smoking cessation management in adults", section on 'Psychiatric illness'.)

IMPACT OF REDUCING ALCOHOL USE AND QUITTING SMOKING

Cancer-specific benefits — There are very limited data on the cancer-specific outcomes associated with tobacco abstinence or the reduction or discontinuation of alcohol intake in patients who have been diagnosed with cancer. However, cancer survivors would be expected to benefit from these interventions in ways similar to the general population (ie, those without a history of cancer), including a lower risk of a subsequent (ie, second) primary cancer. In particular, such interventions may lead to a lower risk of a smoking-related malignancy, such as cancers of the oral cavity, oropharynx, nasopharynx, hypopharynx, esophagus, nasal cavity, paranasal sinuses, larynx, lung, uterine cervix, ovary (mucinous histology), urinary bladder, kidney, ureter, and myeloid leukemia [92]. (See "Overview of cancer survivorship care for primary care and oncology providers", section on 'Risk of subsequent primary cancer'.)

General health benefits — Although data are limited for the general benefits of quitting smoking and alcohol use among cancer survivors, it is likely that the adoption of healthy lifestyles, including quitting smoking and "low-risk" and moderate or no alcohol consumption [93], may result in health benefits similar to those seen in the general population who also adopt these strategies. (See "Approach to treating alcohol use disorder" and "Overview of smoking cessation management in adults".)

Quitting smoking – Despite limited prospective data, studies suggest that cancer survivors who quit smoking following treatment for their malignancy are likely to benefit as much as (if not more than) those who quit smoking and do not have a history of cancer.

Quitting smoking at the very least appears to have a positive impact on quality of life among cancer survivors. This was shown in a systematic review of medical databases for articles published since the 1980s [94]. Quitting smoking after a diagnosis of cancer was also associated with a better performance status compared with continued smokers.

Some studies also suggest that quitting smoking may impact overall survival in cancer survivors. One analysis aimed to estimate the effects of quitting smoking after a cancer diagnosis using data from the Surveillance, Epidemiology, and End Results (SEER) program in the United States and cancer registry data from New South Wales, Australia [95]. In this study, individuals who continued to smoke eight years after a cancer diagnosis were estimated to have a lower survival compared with nonsmokers, which was seen both in patients from the United States (43 versus 54 percent, respectively) and from Australia (37 versus 49 percent). (See "Benefits and consequences of smoking cessation" and "Benefits and consequences of smoking cessation", section on 'Benefits of smoking cessation'.)

Reducing or discontinuing alcohol consumption – The data evaluating the impact of interventions to reduce or discontinue alcohol consumption in cancer survivors are even more limited, and no prospective studies have been done to inform the benefits of such an intervention. However, limiting alcohol consumption has other health benefits, which are important for patients after treatment for cancer, as in the general population. These benefits are reviewed separately. (See "Overview of the risks and benefits of alcohol consumption" and "Brief intervention for unhealthy alcohol and other drug use: Efficacy, adverse effects, and administration", section on 'Efficacy'.)

SUMMARY

Smoking and alcohol use among cancer survivors – Although the overall prevalence of current smoking among cancer survivors has declined, smoking and tobacco use continues to be an issue for cancer survivors, especially among adolescent and young adult (AYA) cancer survivors. (See 'Tobacco use' above.)

Despite a cancer diagnosis, many cancer survivors also continue to consume alcohol. (See 'Alcohol consumption' above.)

Impact of alcohol and smoking on outcomes after cancer diagnosis – Observational studies suggest that smoking appears to have a deleterious impact on cancer treatment and that alcohol intake (especially moderate to heavy use) increases cancer-related mortality. (See 'Impact of smoking on outcomes after cancer diagnosis' above and 'Impact of alcohol on outcomes after cancer diagnosis' above.)

Evaluation – It is imperative for clinicians working with cancer survivors to screen them for smoking and alcohol use and refer those who are in need for appropriate treatment. The approach to screening should be similar to that used for patients without a history of cancer, in the absence of a specific diagnostic evaluation tailored to cancer survivors. (See 'Evaluation' above.)

Lung cancer screening – Cancer survivors with a smoking history may be candidates for lung cancer screening with low-dose computed tomography (LDCT) of the chest. (See 'Lung cancer screening' above.)

Treatment approaches – There are limited data on interventions specific for cancer survivors, particularly for stopping or decreasing smoking and alcohol use. (See 'Treatment approaches' above.)

Treatment of smoking – The provision of comprehensive tobacco treatment including counseling, medications, and treatment for psychiatric symptoms could result in approximately one-half of patients quitting tobacco, regardless of cancer site or a non-cancer diagnosis. (See 'Treatment of smoking' above.)

Treatment of alcohol use – The treatment for alcohol use requires psychosocial support and pharmacological interventions. (See 'Treatment for alcohol use' above.)

Treatment of psychiatric conditions – Treatment of comorbid psychiatric disorders may aid in the ability to quit smoking and reduce alcohol intake. Treating such conditions may increase resilience, improve the patient's ability to face cancer, and strengthen their ability to maintain abstinence after quitting tobacco [91] or further limiting (or stopping) alcohol intake. (See 'Treating comorbid psychiatric disorders' above.)

Impact of reducing or discontinuing alcohol use and quitting smoking – There are very limited data on the cancer-specific outcomes associated with smoking cessation or the reduction or discontinuation of alcohol intake in patients who have been diagnosed with cancer. However, cancer survivors would be expected to benefit from these interventions in ways similar to the general population (ie, those without a history of cancer), including a lower risk of a subsequent cancer. (See 'Impact of reducing alcohol use and quitting smoking' above.)

ACKNOWLEDGMENT — The UpToDate editorial staff acknowledges Ellen Gritz, PhD, who contributed to previous versions of this topic review.

  1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA 2004; 291:1238.
  2. Cigarette Smoking Among Adults—United States, 2005–2015. Morbidity and Mortality Weekly Report 2016; 65:1205; Centers for Disease Control and Prevention.
  3. Cornelius ME, Wang TW, Jamal A, et al. Tobacco Product Use Among Adults - United States, 2019. MMWR Morb Mortal Wkly Rep 2020; 69:1736.
  4. Substance Abuse and Mental Health Services Administration. Results from the 2010 National Survey on Drug Use and Health: Summary of national findings. (SMA) 11-458, Substance Abuse and Mental Health Services Administration; Rockville, MD 2011.
  5. Prochaska JJ, Das S, Young-Wolff KC. Smoking, Mental Illness, and Public Health. Annu Rev Public Health 2017; 38:165.
  6. Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annu Rev Public Health 2010; 31:297.
  7. O'Hea E, Kroll-Desrosiers A, Cutillo AS, et al. Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes, health care utilization, and health provider behaviors: A multi-site randomized control trial. Patient Educ Couns 2020; 103:607.
  8. Alcohol drinking. IARC Working Group, Lyon, 13-20 October 1987. IARC Monogr Eval Carcinog Risks Hum 1988; 44:1.
  9. Scheideler JK, Klein WMP. Awareness of the Link between Alcohol Consumption and Cancer across the World: A Review. Cancer Epidemiol Biomarkers Prev 2018; 27:429.
  10. Swoboda CM, Walker DM, Huerta TR. Likelihood of Smoking Among Cancer Survivors: An Updated Health Information National Trends Survey Analysis. Nicotine Tob Res 2019; 21:1636.
  11. Cancer Survivors and Smoking. Online Summary of Trends in US Cancer Control Measures, National Cancer Institute, National Institutes of Health 2020. Available at: https://progressreport.cancer.gov/after/smoking (Accessed on May 04, 2020).
  12. Coups EJ, Ostroff JS. A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 2005; 40:702.
  13. Kaul S, Veeranki SP, Rodriguez AM, Kuo YF. Cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult cancer. Cancer 2016; 122:2895.
  14. Arem H, Mama SK, Duan X, et al. Prevalence of Healthy Behaviors among Cancer Survivors in the United States: How Far Have We Come? Cancer Epidemiol Biomarkers Prev 2020; 29:1179.
  15. Gritz ER, Talluri R, Fokom Domgue J, et al. Smoking Behaviors in Survivors of Smoking-Related and Non-Smoking-Related Cancers. JAMA Netw Open 2020; 3:e209072.
  16. Gritz ER, Nisenbaum R, Elashoff RE, Holmes EC. Smoking behavior following diagnosis in patients with stage I non-small cell lung cancer. Cancer Causes Control 1991; 2:105.
  17. Ostroff J, Garland J, Moadel A, et al. Cigarette smoking patterns in patients after treatment of bladder cancer. J Cancer Educ 2000; 15:86.
  18. Ostroff JS, Jacobsen PB, Moadel AB, et al. Prevalence and predictors of continued tobacco use after treatment of patients with head and neck cancer. Cancer 1995; 75:569.
  19. Sanderson Cox L, Patten CA, Ebbert JO, et al. Tobacco use outcomes among patients with lung cancer treated for nicotine dependence. J Clin Oncol 2002; 20:3461.
  20. Lippman SM, Lee JJ, Karp DD, et al. Randomized phase III intergroup trial of isotretinoin to prevent second primary tumors in stage I non-small-cell lung cancer. J Natl Cancer Inst 2001; 93:605.
  21. Walker MS, Vidrine DJ, Gritz ER, et al. Smoking relapse during the first year after treatment for early-stage non-small-cell lung cancer. Cancer Epidemiol Biomarkers Prev 2006; 15:2370.
  22. Centers for Disease Control and Prevention (CDC). Cigarette smoking among adults--United States, 2006. MMWR Morb Mortal Wkly Rep 2007; 56:1157.
  23. Martinez E, Tatum KL, Weber DM, et al. Issues related to implementing a smoking cessation clinical trial for cancer patients. Cancer Causes Control 2009; 20:97.
  24. Rivera C, Rivera S, Fabre E, et al. [Consequences of tobacco smoking on lung cancer treatments]. Rev Pneumol Clin 2016; 72:136.
  25. Frobisher C, Lancashire ER, Reulen RC, et al. Extent of alcohol consumption among adult survivors of childhood cancer: the British Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2010; 19:1174.
  26. Rebholz CE, Kuehni CE, Strippoli MP, et al. Alcohol consumption and binge drinking in young adult childhood cancer survivors. Pediatr Blood Cancer 2012; 58:256.
  27. Webber K, Davies AN. An observational study to determine the prevalence of alcohol use disorders in advanced cancer patients. Palliat Med 2012; 26:360.
  28. Potash AE, Karnell LH, Christensen AJ, et al. Continued alcohol use in patients with head and neck cancer. Head Neck 2010; 32:905.
  29. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. (Ed), Centers for Disease Control and Prevention (US), Atlanta (GA) 2014.
  30. US Department of Health and Human Services. The health consequences of smoking--50 years of progress: A report of the surgeon general. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
  31. Gritz ER, Toll BA, Warren GW. Tobacco use in the oncology setting: advancing clinical practice and research. Cancer Epidemiol Biomarkers Prev 2014; 23:3.
  32. Danson SJ, Rowland C, Rowe R, et al. The relationship between smoking and quality of life in advanced lung cancer patients: a prospective longitudinal study. Support Care Cancer 2016; 24:1507.
  33. Duffy SA, Ronis DL, Valenstein M, et al. Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients. Psychosomatics 2007; 48:142.
  34. Jang S, Prizment A, Haddad T, et al. Smoking and quality of life among female survivors of breast, colorectal and endometrial cancers in a prospective cohort study. J Cancer Surviv 2011; 5:115.
  35. Toll BA, Brandon TH, Gritz ER, et al. Assessing tobacco use by cancer patients and facilitating cessation: an American Association for Cancer Research policy statement. Clin Cancer Res 2013; 19:1941.
  36. Pytynia KB, Grant JR, Etzel CJ, et al. Matched-pair analysis of survival of never smokers and ever smokers with squamous cell carcinoma of the head and neck. J Clin Oncol 2004; 22:3981.
  37. Do KA, Johnson MM, Lee JJ, et al. Longitudinal study of smoking patterns in relation to the development of smoking-related secondary primary tumors in patients with upper aerodigestive tract malignancies. Cancer 2004; 101:2837.
  38. Khuri FR, Kim ES, Lee JJ, et al. The impact of smoking status, disease stage, and index tumor site on second primary tumor incidence and tumor recurrence in the head and neck retinoid chemoprevention trial. Cancer Epidemiol Biomarkers Prev 2001; 10:823.
  39. Browman GP, Wong G, Hodson I, et al. Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Engl J Med 1993; 328:159.
  40. Browman GP, Mohide EA, Willan A, et al. Association between smoking during radiotherapy and prognosis in head and neck cancer: a follow-up study. Head Neck 2002; 24:1031.
  41. Garces YI, Schroeder DR, Nirelli LM, et al. Tobacco use outcomes among patients with head and neck carcinoma treated for nicotine dependence: a matched-pair analysis. Cancer 2004; 101:116.
  42. Hoff CM, Grau C, Overgaard J. Effect of smoking on oxygen delivery and outcome in patients treated with radiotherapy for head and neck squamous cell carcinoma--a prospective study. Radiother Oncol 2012; 103:38.
  43. Duffy SA, Ronis DL, McLean S, et al. Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma. J Clin Oncol 2009; 27:1969.
  44. Gillison ML, Zhang Q, Jordan R, et al. Tobacco smoking and increased risk of death and progression for patients with p16-positive and p16-negative oropharyngeal cancer. J Clin Oncol 2012; 30:2102.
  45. Balduyck B, Sardari Nia P, Cogen A, et al. The effect of smoking cessation on quality of life after lung cancer surgery. Eur J Cardiothorac Surg 2011; 40:1432.
  46. Chen J, Qi Y, Wampfler JA, et al. Effect of cigarette smoking on quality of life in small cell lung cancer patients. Eur J Cancer 2012; 48:1593.
  47. Steinberger E, Kollmeier M, McBride S, et al. Cigarette smoking during external beam radiation therapy for prostate cancer is associated with an increased risk of prostate cancer-specific mortality and treatment-related toxicity. BJU Int 2015; 116:596.
  48. Kenfield SA, Stampfer MJ, Chan JM, Giovannucci E. Smoking and prostate cancer survival and recurrence. JAMA 2011; 305:2548.
  49. Holmes MD, Murin S, Chen WY, et al. Smoking and survival after breast cancer diagnosis. Int J Cancer 2007; 120:2672.
  50. Peppone LJ, Mustian KM, Morrow GR, et al. The effect of cigarette smoking on cancer treatment-related side effects. Oncologist 2011; 16:1784.
  51. Simmons VN, Litvin EB, Jacobsen PB, et al. Predictors of smoking relapse in patients with thoracic cancer or head and neck cancer. Cancer 2013; 119:1420.
  52. Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 2010; 340:b5569.
  53. Tucker MA, Murray N, Shaw EG, et al. Second primary cancers related to smoking and treatment of small-cell lung cancer. Lung Cancer Working Cadre. J Natl Cancer Inst 1997; 89:1782.
  54. Garces YI, Yang P, Parkinson J, et al. The relationship between cigarette smoking and quality of life after lung cancer diagnosis. Chest 2004; 126:1733.
  55. Duffy SA, Terrell JE, Valenstein M, et al. Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients. Gen Hosp Psychiatry 2002; 24:140.
  56. Gritz ER, Carmack CL, de Moor C, et al. First year after head and neck cancer: quality of life. J Clin Oncol 1999; 17:352.
  57. Shiels MS, Gibson T, Sampson J, et al. Cigarette smoking prior to first cancer and risk of second smoking-associated cancers among survivors of bladder, kidney, head and neck, and stage I lung cancers. J Clin Oncol 2014; 32:3989.
  58. Jin M, Cai S, Guo J, et al. Alcohol drinking and all cancer mortality: a meta-analysis. Ann Oncol 2013; 24:807.
  59. Saieva C, Bardazzi G, Masala G, et al. General and cancer mortality in a large cohort of Italian alcoholics. Alcohol Clin Exp Res 2012; 36:342.
  60. Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update, clinical practice guideline. Public Health Service, US Department of Health and Human Services; Rockville, MD 2008.
  61. Blumenthal D, Tavenner M. The "meaningful use" regulation for electronic health records. N Engl J Med 2010; 363:501.
  62. Field JK, Vulkan D, Davies MPA, et al. Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis. Lancet Reg Health Eur 2021; 10:100179.
  63. Joseph AM, Rothman AJ, Almirall D, et al. Lung Cancer Screening and Smoking Cessation Clinical Trials. SCALE (Smoking Cessation within the Context of Lung Cancer Screening) Collaboration. Am J Respir Crit Care Med 2018; 197:172.
  64. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th revised ed, American Psychiatric Association; Washington, DC 2000.
  65. Substance Abuse and Mental Health Services Administration. Results from the 2011 National Survey on Drug Use and Health: Summary of national findings. (SMA) 12-4713, Substance Abuse and Mental Health Services Administration; Rockville, MD 2012.
  66. 2017 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration; Center for Behavioral Health Statistics and Quality, Rockville, 2018.
  67. Lasser K, Boyd JW, Woolhandler S, et al. Smoking and mental illness: A population-based prevalence study. JAMA 2000; 284:2606.
  68. Barkley RA, Fischer M, Edelbrock CS, Smallish L. The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry 1990; 29:546.
  69. Borland BL, Heckman HK. Hyperactive boys and their brothers. A 25-year follow-up study. Arch Gen Psychiatry 1976; 33:669.
  70. Breslau N, Johnson EO, Hiripi E, Kessler R. Nicotine dependence in the United States: prevalence, trends, and smoking persistence. Arch Gen Psychiatry 2001; 58:810.
  71. Covey LS, Hughes DC, Glassman AH, et al. Ever-smoking, quitting, and psychiatric disorders: Evidence from the Durham, North Carolina, epidemiologic catchment area. Tob Control 1994; 3:222.
  72. Glassman AH, Helzer JE, Covey LS, et al. Smoking, smoking cessation, and major depression. JAMA 1990; 264:1546.
  73. Hartsough CS, Lambert NM. Pattern and progression of drug use among hyperactives and controls: a prospective short-term longitudinal study. J Child Psychol Psychiatry 1987; 28:543.
  74. Williams JM, Ziedonis D. Addressing tobacco among individuals with a mental illness or an addiction. Addict Behav 2004; 29:1067.
  75. Baigent MF. Understanding alcohol misuse and comorbid psychiatric disorders. Curr Opin Psychiatry 2005; 18:223.
  76. Pacek LR, Storr CL, Mojtabai R, et al. Comorbid Alcohol Dependence and Anxiety Disorders: A National Survey. J Dual Diagn 2013; 9.
  77. Kaufmann CN, Chen LY, Crum RM, Mojtabai R. Treatment seeking and barriers to treatment for alcohol use in persons with alcohol use disorders and comorbid mood or anxiety disorders. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1489.
  78. Guimond AJ, Croteau VA, Savard MH, et al. Predictors of Smoking Cessation and Relapse in Cancer Patients and Effect on Psychological Variables: an 18-Month Observational Study. Ann Behav Med 2017; 51:117.
  79. Westmaas JL, Thewes B, Séguin Leclair C, Lebel S. Smoking versus quitting and fear of cancer recurrence 9 years after diagnosis in the American Cancer Society's Longitudinal Study of Cancer Survivors-I (SCS-I). Cancer 2019; 125:4260.
  80. Grant BF, Hasin DS, Chou SP, et al. Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2004; 61:1107.
  81. Cancer Care Settings and Smoking Cessation. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/tobacco/patient-care/care-settings/cancer/index.htm (Accessed on February 14, 2022).
  82. Smoking Cessation. National Comprehensive Cancer Network. Available at: https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1463 (Accessed on February 14, 2022).
  83. McBride CM, Ostroff JS. Teachable moments for promoting smoking cessation: the context of cancer care and survivorship. Cancer Control 2003; 10:325.
  84. Gosselin MH, Mahoney MC, Cummings KM, et al. Evaluation of an intervention to enhance the delivery of smoking cessation services to patients with cancer. J Cancer Educ 2011; 26:577.
  85. Park ER, Japuntich S, Temel J, et al. A smoking cessation intervention for thoracic surgery and oncology clinics: a pilot trial. J Thorac Oncol 2011; 6:1059.
  86. Cooley ME, Wang Q, Johnson BE, et al. Factors associated with smoking abstinence among smokers and recent-quitters with lung and head and neck cancer. Lung Cancer 2012; 76:144.
  87. Nayan S, Gupta MK, Strychowsky JE, Sommer DD. Smoking cessation interventions and cessation rates in the oncology population: an updated systematic review and meta-analysis. Otolaryngol Head Neck Surg 2013; 149:200.
  88. Cinciripini PM, Karam-Hage M, Kypriotakis G, et al. Association of a Comprehensive Smoking Cessation Program With Smoking Abstinence Among Patients With Cancer. JAMA Netw Open 2019; 2:e1912251.
  89. Latino-Martel P, Arwidson P, Ancellin R, et al. Alcohol consumption and cancer risk: revisiting guidelines for sensible drinking. CMAJ 2011; 183:1861.
  90. LoConte NK, Brewster AM, Kaur JS, et al. Alcohol and Cancer: A Statement of the American Society of Clinical Oncology. J Clin Oncol 2018; 36:83.
  91. Blalock JA, Minnix JA, Karam-Hage M, et al. The effect of mood, anxiety and alcohol use disorders on smoking cessation in cancer patients. J Cog Psychother 2011; 25:82.
  92. Parry C, Kent EE, Mariotto AB, et al. Cancer survivors: a booming population. Cancer Epidemiol Biomarkers Prev 2011; 20:1996.
  93. Klein WMP, Jacobsen PB, Helzlsouer KJ. Alcohol and Cancer Risk: Clinical and Research Implications. JAMA 2020; 323:23.
  94. Florou AN, Gkiozos IC, Tsagouli SK, et al. Clinical significance of smoking cessation in subjects with cancer: a 30-year review. Respir Care 2014; 59:1924.
  95. Sitas F, Weber MF, Egger S, et al. Smoking cessation after cancer. J Clin Oncol 2014; 32:3593.
Topic 17024 Version 14.0

References