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Smoking Cessation and Mortality Risk in Cancer Survivorship: Real-World Data From a National Cancer
Steven Tohmasi1,2, Timothy B Baker3,4, Brendan T Heiden2
11Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
Journal of the National Comprehensive Cancer Network : JNCCN
|October 9, 2025
Summary
Quitting smoking after a cancer diagnosis significantly improves overall survival (OS) for all patients, including those with advanced cancer. Oncology care should systematically support smoking cessation for all cancer survivors who smoke.
Area of Science:
- Oncology
- Public Health
- Epidemiology
Background:
- Evidence-based tobacco cessation treatments are recommended for all cancer patients who smoke.
- These treatments are underutilized in oncology care due to time and resource constraints.
- The impact of smoking cessation on long-term outcomes, especially in advanced cancer, requires further evaluation.
Purpose of the Study:
- To evaluate the association between smoking cessation and overall survival (OS) in cancer survivors who smoke.
- To assess this association across all cancer disease stages.
Main Methods:
- An observational cohort study of 13,282 cancer patients was conducted.
- Patients who smoked were prospectively followed for smoking cessation within 6 months.
- Multivariable Cox proportional hazards models and Kaplan-Meier methods assessed the impact on 2-year OS.
Main Results:
- Current smokers at index visit had a 35% higher risk of all-cause mortality compared to never-smokers (aHR, 1.35).
- Patients who continued smoking postdiagnosis had a 97% higher risk of all-cause mortality compared to quitters (aHR, 1.97).
- Continued smoking was associated with increased mortality in advanced-stage cancer patients (aHR, 2.11).
Conclusions:
- Postdiagnosis smoking cessation is linked to improved OS in cancer survivors, including those with advanced disease.
- Smoking cessation support is crucial for all cancer survivors who smoke, regardless of cancer type or stage.
- Systematic implementation of smoking cessation interventions in oncology settings can reduce mortality rates.
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