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Many Keep Smoking After Cancer Diagnosis

Posted on: Monday, 28 November 2005, 06:00 CST

By Liz Szabo

Up to half of smokers continue to light up cigarettes after being diagnosed with cancer even though tobacco use substantially increases a patient's risk of death, a new study shows. Some cancer patients never quit at all, while others relapse after they finish therapy, according to an article online today in the journal Cancer.

"This is like putting a gun in your mouth," says David Johnson, deputy director of Nashville's Vanderbilt-Ingram Cancer Center, who was not involved in the research. "That just illustrates the powerful hold that nicotine has on people."

Researchers who evaluated existing research on the subject concluded that smoking makes cancer therapies less effective and increases the risk of heart problems, infections, lung trouble and new tumors.

"It really is never too late to stop smoking," says Damon Vidrine, an author of the study and a postdoctoral fellow at M.D. Anderson Cancer Center in Houston. He notes that patients who stop smoking -- before, during or after cancer therapy -- are better off than those who continue using tobacco. In particular, smoking can:

*Make patients less likely to respond to radiation therapy.

*Affect the way that the liver processes medication, which could make chemotherapy less effective.

*Prevent surgical wounds from healing and increase the risk of infections.

*Interfere with tissue grafts, such as those used to reconstruct a breast after a mastectomy. Transplanted tissue that dies has to be cut away. The idea of losing a breast for the second time can be "psychologically devastating" to cancer survivors, Vidrine says.

Quitting smoking is tough even in the best of circumstances, says Glen Morgan, a psychologist with the National Cancer Institute's tobacco control research branch, who was not involved in the study. According to the American Cancer Society, 70% of smokers want to quit, but only 5% succeed.

The trauma of being diagnosed with cancer can make it harder to quit because many smokers use cigarettes to cope with stress, Morgan says. He notes that smokers are most likely to quit if they develop a careful game plan -- something that is tougher to do when life is turned upside down by cancer. But Morgan notes that cancer also can motivate smokers to quit.

Doctors can play a key role, too, by prescribing medications that double the chances of quitting for good.

Vanderbilt's Johnson says doctors should ask patients about smoking at every visit.

But Vidrine says some physicians are reluctant to press the issue.

"Some doctors say, 'This patient is so stressed now that I don't want to even ask them to quit,'" Vidrine says. But if a patient's smoking causes her breast reconstruction to fail, "her distress is going to go through the roof."

Michael Augustine, 57, of Goodlettsville, Tenn., says he tried to quit smoking many times over two decades. He finally gave up cigarettes several years ago after he had trouble breathing while painting his house. Doctors recently detected precancerous cells in phlegm from his lungs. Those health scares provide a good reason to stay away from cigarettes, Augustine says. "I'm just happy to be alive."

(c) Copyright 2005 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

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