Smoking Cessation and Lung Cancer: Oncology Nurses Can Make a Difference

doi:10.1016/j.soncn.2007.11.008

Seminars in Oncology Nursing

Volume 24, Issue 1, February 2008, Pages 16-26

https://doi.org/10.1016/j.soncn.2007.11.008 Get rights and content

Objectives

To provide an overview of the impact of smoking after a diagnosis of lung cancer, discuss the relationship between smoking cessation and improved outcomes, present information about tobacco-dependence treatments, reimbursement for these treatments, and resources available for patients and health care professionals.

Data Sources

Published articles, reports, websites, and research studies.

Conclusion

Prevention of tobacco use and cessation are primary ways to prevent lung cancer. However, even after a diagnosis of lung cancer, smoking cessation is important in improving survival and quality of life. Although effective treatments are available to help smokers quit, persistent efforts over repeated contacts may be necessary to achieve long-term cessation.

Implications for Nursing Practice

Oncology nursing action is essential in the identification of and intervention with patients who struggle with tobacco dependence after diagnosis.

Section snippets

Smoking Prevalence Rates and the Benefits of Cessation

The prevalence of smoking among newly diagnosed lung cancer patients tends to be higher than the general population. Estimates for the prevalence of smoking have ranged from 24% to 60% among newly diagnosed lung cancer patients compared with 12% to 29% among the general US population.5, 6, 7 Although the diagnosis of lung cancer presents a compelling reason to quit smoking, studies have estimated that between 8% to 17% of smokers continue to smoke after diagnosis.5, 6 This finding underscores

The Impact of Smoking on Outcomes of Cancer Treatment Modalities

Smoking can negatively affect outcomes of cancer treatments through direct and indirect effects. Tobacco smoke and its constituents have active biological effects that can interact with cancer treatments. Moreover, the type and severity of smoking-related comorbidities may affect the type of cancer treatments chosen. For example, severe lung or cardiovascular disease may limit the option for or extent of lung cancer surgery, use of radiation treatment, or type of chemotherapy agent that can be

Understanding Tobacco Dependence

In 1988, the Surgeon General's Report on Nicotine Addiction¹⁸ provided conclusive evidence that tobacco is addicting in the same way as other drugs that are responsible for addiction. In fact, nicotine, the dependence-producing substance in tobacco, is similar to heroin and cocaine in its addictive properties. This landmark report promoted the fact that tobacco dependence is a chronic condition characterized by periods of abstinence and relapse, thus requiring repeated interventions by

Conclusion

Smoking cessation after the diagnosis of lung cancer is essential to improve clinical outcomes. Although effective TDT are available to help smokers quit smoking, persistent efforts over repeated contacts may be necessary to achieve long-term cessation. Oncology nurses have the potential to make an enormous difference in the successful integration of tobacco-dependence services into clinical settings. Further knowledge and training in TDT is needed to make this a reality.

Mary E. Cooley PhD, APRN, BC: Nurse Scientist, Phyllis F. Cantor Center, Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA.

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The Role and Scope of Prehabilitation in Cancer Care
2020, Seminars in Oncology Nursing
Citation Excerpt :
Lung cancer is often related to smoking.2 Smoking cessation has both short- and long-term benefits, and oncology nurses can assist patients with cessation.22 Often, patients with lung cancer have chronic obstructive pulmonary disease, increasing both the risk and subsequently the rewards of exercise.
To recognize cancer prehabilitation as a pretreatment regimen to increase functional status for patients requiring cancer treatment. This article presents current evidence addressing the efficacy and benefits of prehabilitation regimens in different cancer survivor populations.
Studies and case reports in the PubMed database.
Cancer prehabilitation may improve outcomes. Prehabilitation may include targeted or whole-body exercise, nutrition, education, psychologic counseling, and smoking cessation. Opportunities exist to further improve access to and delivery of multimodal prehabilitation, and nurses play a critical role in connecting patients to these services.
Oncology nurses who are knowledgeable of cancer treatment-related effects are poised to assess survivors for existing impairments, advocate for prehabilitation for existing and potential morbidities, and monitor functional status over time. As patient educators, they are key to informing cancer survivors about the role of prehabilitation.
Le sevrage tabagique dans le cancer bronchique: les méthodes et les résultats; place de la e-cigarette
2019, Revue des Maladies Respiratoires Actualites
En France, le nombre de décès liés au tabac est estimé à 78 000/an, dont 47 000 par cancer et plus de 28 000 par cancer bronchique (CB). L’arrêt du tabac est la mesure la plus efficace pour limiter l’épidémie du CB, mais est aussi un élément important dans la prise en charge des patients atteints de CB quel que soit le stade. Dans les cancers localisés, la poursuite du tabac est associée à une diminution de la survie par augmentation du risque de récidive et de développer un deuxième cancer. En période péri-opératoire, le sevrage tabagique permet de limiter les complications infectieuses et la durée d’hospitalisation. Quel que soit le stade du cancer, le sevrage permet d’améliorer la dyspnée, l’appétit et de réduire l’asthénie; ceci se traduit par une amélioration de la qualité de vie. Le tabac entraine une addiction forte avec une dépendance physique, psychologique et comportementale. La substitution nicotinique et la varénicline sont indiquées en cas de dépendance physique à la nicotine. La cigarette électronique peut être considérée comme un outil d’aide au sevrage tabagique. Les thérapies cognitives – comportementales permettent d’aider le fumeur à se débarrasser de son comportement, ont une place dans la prévention de la rechute.
In France, the number of tobacco-related deaths is estimated at 78 000 per year, including 47,000 from cancer and more than 28 000 from lung cancer (LC). Smoking cessation is the most effective measure to reduce the epidemic of LC, but is also important in the management of patients with LC regardless on stage. In localized cancers, continuing smoking is associated with decreased survival by increasing the risk of recurrence and of developing a second cancer. In the perioperative period, smoking cessation can reduce infectious complications and length of hospitalization. At all stages of the cancer, smoking cessation improves dyspnea, appetite and reduces fatigue; smoking cessation is associated with improved quality of life. Tobacco addiction causes a strong physical, psychological and behavioral dependence. Nicotine replacement therapy and varenicline are indicated in cases of physical nicotine addiction. The electronic cigarette can be considered as a smoking cessation tool. Cognitive behavioral therapy allows the smoker to help get rid of the smoking habit and is important in preventing relapse.
Smoking cessation: Avoiding cancer, reducing treatments toxicities and risk of relapse
2018, Revue des Maladies Respiratoires Actualites
En France, le nombre de décès liés au tabac est estimé à 73 000/an, dont 44 000 par cancer et plus de 20 000 par cancer bronchique (CB). L’arrêt du tabac est la mesure la plus efficace pour limiter l’épidémie du CB mais est aussi un élément important dans la prise en charge des patients atteints de CB quel que soit le stade. Dans les cancers localisés, la poursuite du tabac est associée à une diminution de la survie par augmentation du risque de récidive et de développer un deuxième cancer. En période péri-opératoire, le sevrage tabagique permet de limiter les complications infectieuses et la durée d’hospitalisation. Quel que soit le stade du cancer, le sevrage permet d’améliorer la dyspnée, l’appétit et de réduire l’asthénie ; ceci se traduit par une amélioration de la qualité de vie. Le tabac entraine une addiction forte avec une dépendance physique, psychologique et comportementale. La substitution nicotinique et la varénicline sont indiquées en cas de dépendance physique à la nicotine. Les thérapies cognitives - comportementales permettent d’aider le fumeur à se débarrasser de son comportement, ont une place dans la prévention de la rechute.
In France, the number of tobacco-related deaths is estimated at 73,000 per year, including 44,000 from cancer and more than 20,000 from lung cancer (LC). Smoking cessation is the most effective measure to reduce the epidemic of LC, but is also important in the management of patients with LC regardless on stage. In localized cancers, continuing smoking is associated with decreased survival by increasing the risk of recurrence and of developing a second cancer. In the perioperative period, smoking cessation can reduce infectious complications and length of hospitalization. At all stages of the cancer, smoking cessation improves dyspnea, appetite and reduces fatigue; smoking cessation is associated with improved quality of life. Tobacco addiction causes a strong physical, psychological and behavioral dependence. Nicotine replacement therapy and varenicline are indicated in cases of physical nicotine addiction. Cognitive behavioral therapy allows the smoker to help get rid of the smoking habit and is important in preventing relapse.
Implementation of Tobacco Dependence Treatment Programs in Oncology Settings
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Citation Excerpt :
Implementation, however, requires planning and collaboration among many facets of the health care system.22 Nurses educated about tobacco control and smoking cessation are critical to these efforts and have proven to effectively deliver such interventions.15,26,27 Although grass roots advocacy can be effective, buy-in and commitment from health care systems' leadership and other stakeholders are important for sustainability.
To discuss strategies for implementing tobacco dependence treatment in cancer care and the role of oncology nurses.
Evidence-based clinical practice guidelines for tobacco dependence treatment, published literature and Web sites.
There are many benefits of quitting smoking after a diagnosis of cancer. Implementation of tobacco dependence treatment can improve patient outcomes but requires system changes. The electronic health care record, access to telephone quit lines for smoking cessation, resources for providers, and changes in insurance coverage all facilitate the delivery of treatment.
Oncology nurses can play an important role in championing tobacco dependence treatment in cancer care.
A pilot randomized controlled trial of smoking cessation in an outpatient respirology clinic
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Supportive care in lung cancer: Milestones over the past 40 years
2015, Journal of Thoracic Oncology
Citation Excerpt :
Not only is a risk factor for health and well-being but also it interferes with interventions with patients. Policy changes are needed to ensure that treatment of tobacco dependence occurs during the entire continuum of LC care.94 Addressing tobacco use as part of supportive care is an important part of reducing cancer-related morbidity and mortality.95
The evolution of supportive care in lung cancer (LC) is the focus of this article, which aims to present an overall picture of the developments in the field, highlight milestones over the past four decades, and provide directions for future research and practice. Although in the 1970s this study was minimal, from the 1980s onwards, there was an expansion of the range of topics covered in the literature, reflecting the importance of supportive care to clinical practice. These areas include the identification of supportive care needs in LC, symptoms and symptom management, psychosocial aspects and coping with LC (including support of caregivers), quality of life issues and the development and testing of patient-reported outcomes, the option of best supportive care versus treatment, smoking cessation before and after diagnosis of LC, and service delivery models. This article celebrates the evolution of supportive LC care over the past 40 years alongside recognizing that more work needs to be done in the future and new research foci need to be developed to meet the current needs of patients with LC. The role and the continuous efforts of the International Association of the Study of Lung Cancer, including the sixteenth World Conference on Lung Cancer in 2015 to meet this goal, will be crucial and strategic in the future.

View all citing articles on Scopus

Mary E. Cooley PhD, APRN, BC: Nurse Scientist, Phyllis F. Cantor Center, Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA.

Rebecca L. Sipples, APRN: Thoracic Oncology Nurse Practitioner, Yale Comprehensive Cancer Center, Yale University School of Nursing, New Haven, CT.

Meagan Murphy, BS: Research Intern, Phyllis F. Cantor Center, Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA.

Linda Sarna RN, DNSc, FAAN: Professor, University of California-Los Angeles, School of Nursing, Los Angeles, CA.

: Supported in part by grants from the National Cancer Institute (grant no. 1K07 CA92692, Mary E. Cooley, PI).

View full text

Smoking Cessation and Lung Cancer: Oncology Nurses Can Make a Difference

Objectives

Data Sources

Conclusion

Implications for Nursing Practice

Section snippets

Smoking Prevalence Rates and the Benefits of Cessation

The Impact of Smoking on Outcomes of Cancer Treatment Modalities

Understanding Tobacco Dependence

Conclusion

Chest

Lancet

Chest

Cancer Detect Prev

Int J Oral Maxillofac Surg

J Pain Symptom Manage

J Thorac Oncol

Mayo Clin Proc

Nurs Outlook

Cancer Facts and Figures–2007

Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers

Ann Intern Med

Smoking abstinence and small cell lung cancer survival: an association

JAMA

Nicotine dependence treatment for patients with cancer

Cancer

Tobacco use in women with lung cancer

Ann Behav Med

Centers for Disease Control and Prevention: State-specific prevalence of current cigarette smoking among adults and secondhand smoke rules and policies in homes and workplaces

MMWR Morbid Mortal Wkly Rep

US Department of Health and Human Services: Clinical practice guideline: treating tobacco use and dependence. A report from the surgeon general

Does smoking cessation improve health-related quality of life

Ann Behav Med