Survival Outcomes of a Smoking Cessation Treatment Program After Diagnosis of Bladder Cancer

Smoking is the strongest modifiable risk factor for the development of bladder cancer. The benefits of smoking abstinence following a bladder cancer diagnosis are uncertain. Our objective was to determine the association of smoking abstinence with survival following the diagnosis of bladder cancer compared with continued smoking.

A subset of 169 patients from the Tobacco Research and Treatment Program (TRTP) was identified following a diagnosis of urothelial bladder cancer between 2006 and 2022. Individualized tobacco treatment strategies were employed, and self-reported abstinence information was collected at 3, 6, and 9 mo following consultation. The primary outcome was overall survival (OS), analyzed according to smoking abstinence status. Secondary outcomes included cancer-specific survival (CSS), recurrence-free survival (RFS), and metastasis-free survival (MFS).

Smoking abstinence rates were 43%, 44%, and 38% at the 3-, 6-, and 9-mo assessments, respectively. After a median follow-up of 5.7 yr, abstinence at 3, 6, and 9 mo was independently associated with superior OS (adjusted hazard ratios were 0.56, 0.45, and 0.51, respectively). CSS and RFS were likewise significantly improved whenever abstinence was achieved at any follow-up point. Limitations include the predominantly White, male cohort, which may limit generalizability to more diverse populations.

Smoking abstinence following the diagnosis of bladder cancer was associated with improved survival in our prospective cohort. Smoking cessation should be strongly encouraged in all patients with bladder cancer. IRB protocol number: DR07-0884 (Institutional Review Board at The University of Texas MD Anderson Cancer Center).