NCCN Unveils New Smoking Cessation Guidelines

The most recent Surgeon General Report on Smoking and Health initiated the decision to create smoking cessation guidelines for cancer patients, Peter G. Shields, MD, deputy director of The Ohio State University Comprehensive Cancer Center — James Cancer Hospital and Solove Research Institute, said during his session announcing the new NCCN Guidelines.

Treating cancer patients is a difficult process, and smoking cessation is a lesser priority, Dr Shields said, but smoking decreases the efficacy of therapy and can cause complications for surgery and bone marrow transplants. Furthermore, smoking is common among cancer patients. The rate of smoking among cancer patients varies, depending on the type of cance,r from 10% to 50%.

The Guidelines are supposed to make broaching the topic of smoking cessation easier for physicians, who often view the discussion as too complex.

“Only about 50% of oncologists actually provide advice to quit, and even if they do they do not provide specific advice on how to do this,” he said.

The important thing to keep in mind, Dr Shields explained, is to explain the complications that can arise for patients who continue smoking. Once patients have been diagnosed with cancer, they think quitting smoking is not worth it, but there are health benefits of smoking cessation that apply to patients in any stage of cancer.

“If you give them the message that ‘This may increase your complication rate’ and you’re giving someone therapies for a cure, you may affect their lives in a second area of cancer risk by taking advantage of this teachable moment,” Dr Shields said.

The Guidelines were not just taken from guidelines already present for the general population, but created with cancer patients and cancer survivors in mind. The Guidelines include first-, second-, and third-line therapies, and state that behavior therapy needs to be used in addition to pharmacotherapy.

The Guidelines start with evaluating and assessing the patient and determining whether he or she is a current smoker or someone who quit less than a month ago, a former smoker who quit more than 30 days ago, or someone who has never smoked or quit longer than 3 years ago.

For the first 2 categories, the Guidelines explain how to determine if they are high risk or low risk for relapse and how to convince current smokers to quit. The Guidelines also detail the type of therapies to use to ensure that smokers stay quit.