BACKGROUND AND PURPOSE:

• Evidence is limited if smoking cessation following a diagnosis of non-small cell lung cancer (NSCLC) is beneficial
• Sheikh et al. (Ann. Intern. Med., 2021) examined whether quitting smoking after diagnosis of lung cancer affects the risk for disease progression and mortality

METHODS:

• Prospective study
• Participants
  • Early-stage (IA-IIIA) NSCLC
  • Current smokers at time of diagnosis
• Exposure
  • Cessation of smoking
• Study design
  • Recruitment occurred between 2007 and 2016
  • Follow-up annually through 2020
• Primary outcomes
  • Overall survival
  • Progression-free survival
  • Lung cancer-specific mortality

RESULTS:

• 517 current smokers
  • Average 7 years follow-up
• Mortality and cancer progression
  • Death: 63.2%
  • Cancer-specific deaths: 52.8%
  • Tumor progression (local recurrence or metastasis): 33.7%
• Adjusted median overall survival time was 21.6 months higher among patients who had quit smoking than those who continued smoking (P=0.001)
  • Quit smoking: 6.6 years
  • Continued smoking: 4.8 years
• Patients who quit smoking also had a higher 5-year
  • Overall survival (P=0.001)
    • Quit smoking: 60.6%
    • Continued smoking: 48.6%
  • Progression-free survival (P=0.004)
    • Quit smoking: 54.4%
    • Continued smoking: 43.8%
• After adjustments, smoking cessation remained associated with decreased risk for
  • All-cause mortality
    • Hazard ratio (HR) 0.67 (95% CI, 0.53 to 0.85)
  • Cancer-specific mortality
    • HR 0.75 (95% CI, 0.58 to 0.98)
  • Disease progression
    • HR 0.70 (95% CI, 0.56 to 0.89)
• Similar effects were observed among
  • Mild to moderate and heavy smokers
  • Patients with earlier and later cancer stages

CONCLUSION:

• Those who quit had a lower risk of all-cause and cancer-specific mortality, as well as disease progression, at 5 years
• An editorial notes that this study fills important knowledge gaps including large sample size and longer follow-up and therefore

The results of this new study strengthen the case for making tobacco cessation treatment a standard component of routine health care for all patients with cancer

It is not too late for cigarette smokers with cancer and cancer survivors to benefit from becoming smoke-free

Learn More – Primary Sources:

Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality: A Prospective Cohort Study

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