As the oncologist noted, patients who continue to smoke during antitumor therapy have a greater risk of severe reactions from the mucous membranes, and more often the risk of cardiovascular complications. Such patients experience impaired wound healing due to ischemia, they are more likely to suffer from respiratory complications in the intensive care unit, and the number of infections increases. Continued smoking after an oncological diagnosis can significantly reduce the effectiveness of antitumor therapy due to the deterioration of the metabolism of chemotherapy drugs in the liver and the development of resistance. Cigarette smoking can cause anemia, which also reduces the effectiveness of treatment. As a result, the patient “gets” a high risk of developing a relapse and reduces the chance of survival.
Smoking cessation should become an essential component of cancer treatment in all cancer programs – from prevention and diagnosis to treatment and palliative care, Sufiya Safina is sure. Under her leadership, Kazan scientists conducted a study in which they compared data on the impact of tobacco smoking on the prognosis of cancer patients and analyzed the awareness and readiness of patients with malignant neoplasms to quit smoking.
“The purpose of the study is to analyze and identify the level of awareness of patients with malignant neoplasms about the possibilities of quitting smoking, their readiness to quit smoking, and also to study the impact of these factors on overall survival,” said Sufiya Safina. — A total of 556 patients aged from 26 to 73 years were interviewed, undergoing treatment at the Republican Clinical Oncology Dispensary of the Ministry of Health of the Republic of Tatarstan named after. prof. M.Z. Seagal, 226 (40%) of whom were active smokers at the time of the survey.
The study showed that 57.6% of respondents started smoking before the age of 18, with 82% of them smoking for more than five years, and 67% smoking more than a pack a day. 88% of respondents tried to quit smoking, 63% were highly motivated to give up the bad habit, but only 14% succeeded. 45 patients (8%) had a history of concomitant pathologies of the cardiovascular and respiratory systems. The high level of compliance (adherence to treatment) of the respondents showed the need to provide patients with assistance in quitting smoking. This means that smoking cessation should be part of the standard of care for cancer.
“We are faced with ignoring a large number of smoking patients and the lack of individualization of approaches to their treatment, taking into account the influence of bad habits,” stated the oncologist. “Because smoking leads to accelerated elimination of anticancer drugs from the body, it can be assumed that in smokers (including those who have recently quit smoking), increasing the daily dose of drugs may achieve the desired therapeutic effect.” However, to confirm this hypothesis, further studies are needed that compare the results of treatment of cancer patients depending on smoking status and the dose of the drug used.
In addition, according to the oncologist, it is necessary to develop and include in clinical recommendations an algorithm for conducting consultations to help patients quit smoking and train medical personnel in the methods of conducting such consultations. “For patients with low motivation to give up a bad habit, at the first stage it is possible to switch to alternative nicotine delivery products, but with a lower content of toxic substances in the emitted aerosol due to the absence of the combustion process characteristic of traditional cigarettes,” emphasized Sufiya Safina.
Today, despite the efforts of WHO, in most countries existing tobacco control measures have not yet achieved all of their goals, as evidenced by research, published in The Lancet. According to scientists, current WHO policy lacks a harm reduction strategy that involves switching from regular cigarettes to smokeless tobacco products for people who do not quit tobacco use.
Today, more and more scientists are calling for attention to scientific data on the role of innovative nicotine delivery devices as a less harmful alternative to traditional cigarettes. This approach can help patients with cancer who are not motivated to refuse significantly modify their existing risks.
It is necessary to create a standard protocol for assessing smoking status with mandatory inclusion in the patient’s examination card of information about the degree of nicotine dependence and clarification of the sources of nicotine used by the patient, concluded Sufiya Safina.