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. 2020 Aug 5;20(1):726.
doi: 10.1186/s12885-020-07213-5.

Smoking cessation and survival among people diagnosed with non-metastatic cancer

Tracey E Barnett  1 , Yan Lu  2 , Aaron W Gehr  2 , Bassam Ghabach  3 , Rohit P Ojha  4   5
Affiliations

Smoking cessation and survival among people diagnosed with non-metastatic cancer

Tracey E Barnett et al. BMC Cancer. .

Abstract

Background: We aimed to estimate the effects of smoking cessation on survival among people diagnosed with cancer.

Methods: We used data from a Comprehensive Community Cancer Program that is part of a large urban safety-net hospital system. Eligible patients were diagnosed with primary invasive solid tumors between 2013 and 2015, and were current smokers at time of diagnosis. Our exposure of interest was initiation of smoking cessation within 6 months of cancer diagnosis. We estimated inverse probability weighted restricted mean survival time (RMST) differences and risk ratio (RR) for all cause 3-year mortality.

Results: Our study population comprised 369 patients, of whom 42% were aged < 55 years, 59% were male, 44% were racial/ethnic minorities, and 59% were uninsured. The 3-year RMST was 1.8 (95% CL: - 1.5, 5.1) months longer for individuals who initiated smoking cessation within 6 months of cancer diagnosis. The point estimate for risk of 3-year mortality was lower for initiation of smoking cessation within 6 months of diagnosis compared with no initiation within 6 months (RR = 0.72, 95% CL: 0.37, 1.4).

Conclusions: Our point estimates suggest longer 3-year survival, but the results are compatible with 1.5 month shorter or 5.1 longer 3-year overall survival after smoking cessation within 6 months of cancer diagnosis. Future studies with larger sample sizes that test the comparative effectiveness of different smoking cessation strategies are needed for more detailed evidence to inform decision-making about the effect of smoking cessation on survival among cancer patients.

Implications for cancer survivors: The benefits of smoking cessation after cancer diagnosis may include longer survival, but the magnitude of benefit is unclear.

Keywords: Cancer; Cessation; Smoking; Survival.

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Conflict of interest statement

None of the authors have a conflict of interest.

Figures

Fig. 1
Fig. 1
Selection of cancer patients who were smokers at the time of cancer diagnosis
Fig. 2
Fig. 2
Marginal survival curves for cancer patients who initiated or did not initiate smoking cessation within 6 months of cancer diagnosis
Fig. 3
Fig. 3
E-value for the effect of smoking cessation within 6 months of cancer diagnosis on 3-year mortality among cancer patients
See this image and copyright information in PMC

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