Helping patients with cancer (or any person) to quit smoking cigarettes is not easy. The effort often requires repeated attempts. Paul Cinciripini, PhD, Professor and Chair, Department of Behavioral Science, and Director, Tobacco Treatment Program, The University of Texas MD Anderson Cancer Center, updated listeners at the NCCN 22nd Annual Conference about current advances and how they have impacted the 2017 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Smoking Cessation.
“It is most important to consistently engage with your patients, whether they quit or not. Smoking cessation is not a single discrete event. It can take more than a year. The thing to remember is that smoking cessation is not ‘a one and done,’” Dr. Cinciripini stated.
Dr. Cinciripini also discussed the broader picture of nicotine dependence in our society. Currently, 16.7% of men and 13.6% of women in the United States are smokers. Drilling down into the data shows that socioeconomic and education factors are associated with smoking. The rate of smoking is 26% for people below poverty level and 14% for those at or above poverty level. Rates of smoking show a large disparity related to education level; the rate of smoking is 3.6% among individuals who hold a graduate degree and increases to 24.2% for those with an education level below a high school diploma.
Thirty-one percent of all cigarettes are smoked by adults with mental illness; 40% of men and 34% of women with mental illness smoke, Dr. Cinciripini noted.
“Smoking disproportionately occurs among people with the fewest resources,” he said. “There is a gradient across the age span where high and moderate levels of psychological distress are associated with higher levels of smoking,” he added.
However, once people stop smoking, levels of depression, anxiety, and stress are reduced, and mood and quality of life are improved. “The effect sizes of stopping smoking on these parameters are equal to or larger than those of antidepressant treatment,” Dr. Cinciripini continued.
Further, more than 480,000 deaths each year are attributable to smoking. Approximately 30% of lung cancers are smoking-related, as are 8% of other cancers.
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