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Does a Cancer Diagnosis Motivate People to Quit Smoking? JCO Study Says Yes

Jun 08, 2015

A new study in the Journal of Clinical Oncology (JCO) found that smokers recently diagnosed with cancer were significantly more likely to quit smoking than smokers who had not been diagnosed with cancer. The study, “Does a Recent Cancer Diagnosis Predict Smoking Cessation? An Analysis from a Large Prospective US Cohort,” was published online, ahead of print, April 20.

Specifically, about 31 percent of smokers in the study who were diagnosed with cancer had quit smoking within two years of their diagnosis, while only 19 percent of smokers not diagnosed with cancer had quit smoking during a similar time period. At four years, the quit rates for smokers with and without cancer diagnoses was 43 percent and 34 percent, respectively.

One of the goals of the study was to explore whether a cancer diagnosis might elicit a psychological motivation to quit smoking. Therefore, the study excluded smokers with metastatic cancers or with cancers of the esophagus, head and neck, or lung, since for these cancers, physical impediments may be the main reason behind smoking cessation. This study is the first to show that even diagnoses of non-smoking related cancers are associated with higher quit rates.

Cancer diagnosis: a teachable moment

For the study’s first author, J. Lee Westmaas, PhD, the findings underscore the idea that a cancer diagnosis might constitute a “teachable moment,” a time when patients are more open and willing to quit smoking. And this is a willingness doctors might want to capitalize on.

“Hopefully clinicians can look at these results and say, ‘Hey, people are really motivated to quit smoking after a cancer diagnosis and it doesn’t even matter if the cancer is not a smoking-related cancer.’ We should see this as a ‘teachable moment’ in which clinicians can provide access to smoking cessation programs that are evidence-based.”

Access to data on a large number of smokers

Data for the study was derived from the Cancer Prevention Study-II Nutrition Cohort, which includes more than 184,000 men and women in the United States, predominantly over 55 years of age. Participants were asked to report on demographic, medical, lifestyle, and smoking information at the start of the study in 1992 or 1993, and approximately every two years after that until 2009. The JCO study followed over 12,000 participants from the cohort who were smokers at the start of the study and studied how their smoking habits changed over time. 

In addition to finding that the two- and four-year quit rates were significantly higher for smokers who had recently been diagnosed with cancer, the study revealed an interesting gender difference: The effect of a cancer diagnosis on quitting, although seen in both genders, seemed stronger for women than for men. No significant differences emerged between cancer types.

“I think this data shows us that there can be a lot of value in simply asking any cancer patient about whether or not they smoke, providing them with some kind of intervention, and giving them the opportunity to quit smoking,” said Dr. Westmaas.

(ASCO provides numerous evidence-based tools and resources for clinicians wishing to help their patients begin smoking-cessation plans. Resources include, The Tobacco Cessation Guide for Oncology Providers, Practice Tools and Resources, and Coverage for Patient Services).


J. Lee Westmaas is the Director of the Tobacco Control Research, Behavioral Research Center at the American Cancer Society.

Abstract of the original JCO article.

PDF of the original JCO article.


Westmaas, JL, Newton CC, Steven VL, et al. Does a recent cancer diagnosis predict smoking cessation? an analysis from a large prospective us cohort. J Clin Oncol. Epub 2015 April 20.


The Exclusive Coverage series on ASCO.org highlights selected research from JCO and JOP with additional perspective provided by the lead or corresponding author.

@ 2014 American Society of Clinical Oncology


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