Smoking Cessation in Cancer Patients: A Systematic Review

Abstract

Objective: Comprehensive treatment plans for oncology patients including tobacco smoking cessation interventions are essential, as smoking after the diagnosis of a smoking-related cancer negatively impacts many aspects of treatment in this patient population. The primary objective was to evaluate, through a systematic review, smoking cessation interventions and cessation rates in cancer patients. Method: The literature was searched using Medline, EMBASE, Google Scholar, and the Cochrane Library (inception to September 2011) by 3 independent review authors. Included studies described tobacco smoking cessation interventions with patients randomized to usual care or an intervention. The primary outcome measure was cessation rates. Two authors extracted data independently, and disagreements were resolved by consensus. Results: Eight randomized control trials (RCTs) investigating smoking cessation interventions in the oncology patient population were identified. Pooled relative risks were calculated from 2 groups of RCTs of smoking cessation interventions based on follow-up duration. In both groups, the pooled relative risk did not suggest a statistically significant improvement in tobacco cessation compared to usual care. However, a subgroup analysis looking at newer combination interventions within the last 10 years yielded a statistically significant difference in smoking cessation rates. Conclusion: Despite the importance of smoking cessation in oncology patients, there are a paucity of studies. The review suggests that newer combination interventions involving both nonphamacological and pharmacological approaches, in the last decade, yield a statistically significant difference in smoking cessation rates compared to usual care.