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Review
. 2014 Nov;15(12):e568-80.
doi: 10.1016/S1470-2045(14)70266-9. Epub 2014 Oct 26.

The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support

Graham W Warren  1 , Samantha Sobus  2 , Ellen R Gritz  3
Affiliations
Review

The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support

Graham W Warren et al. Lancet Oncol. 2014 Nov.

Abstract

Tobacco use is an established risk factor for the development of several cancers; however, far less work has been done to understand the effects of continued smoking on cancer treatment outcomes, and structured tobacco cessation efforts are not well incorporated into the standard care for patients with cancer. In this Review we discuss the known biological effects of smoking on cancer cell biology and emphasise the clinical effects of continued smoking in patients with cancer treated with chemotherapy or radiotherapy. Although evidence supports the need for inclusion of dedicated tobacco cessation efforts for patients with cancer, clinicians should consider the methods used to provide evidence-based tobacco cessation support and the available resources to deliver and maintain consistent tobacco cessation support. We also address the variables to consider in the design and implementation of a sustainable tobacco cessation programme.

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Conflict of interest statement

Declaration of interests

We declare no competing interests.

Figures

Figure
Figure. The biological effects of cigarette smoke on cancer cell biology
ROS=reactive oxygen species. β-AR=β-adrenergic receptor. nAChR=nicotinic acetylcholine receptor. AHR=aryl hydrocarbon receptor. EGFR=epidermal growth factor receptor. PKC=protein kinase C. PLA2=phospholipase A2. PLC=phosphoinositide phospholipase C. LRP=lipoprotein receptor-related protein. COX=cyclo-oxygenase. LOX=lipoxygenase. MEK=mitogen activated kinase kinase. ERK=extracellular signal related kinase. CYP=cytochrome P450. MRP=multidrug resistance-associated protein. TGF=transforming growth factor. STAT=signal transducer and activator of transcription. JAK=janus kinase. MUC4=mucin 4, cell surface associated. NFKB1=nuclear factor of kappa light polypeptide gene enhancer in B-cells 1. XIAP=x-linked inhibitor of apoptosis. MMP=matrix metalloproteinase. Bcl-xl=B-cell lymphoma extra large. HIF-1α=hypoxia inducible factor 1-α. EGF=epidermal growth factor. EGFR=epidermal growth factor receptor. VEGF=vascular endothelial growth factor. VEGFR=vascular endothelial growth factor receptor. NOS=nitric oxide. synthase. Bcl-2=B-cell lymphoma 2.
See this image and copyright information in PMC

References

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