Prevention and Risk Reduction

Tobacco Cessation

Tobacco use is the leading preventable cause of cancer and cancer deaths. Among the 250 known harmful chemicals in tobacco smoke, at least 69 can cause cancer.

Quitting tobacco is one of the most important actions you can take to improve your health.

Why quit after a cancer diagnosis?

If you or someone you love has been diagnosed with cancer, quitting tobacco is an important step to improve cancer treatment success.

It’s never too late to quit tobacco to gain these potential benefits

More effective cancer treatment. Continued smoking can change the way your body processes certain chemotherapy drugs, leading to poorer treatment outcomes.
Lower risk of cancer coming back or developing a secondary cancer
Fewer side effects from radiation (mouth sores, loss of taste, worse voice quality and bone and soft tissue problems)
Faster recovery and fewer side effects from chemotherapy (infection, fatigue, heart and lung problems and weight loss)
Reduced risk of infection and faster recovery after surgery
Increased energy and easier breathing
Better pain control
Improved quality of life

Quitting tobacco is the best thing you can do to improve your overall health.

20 minutes after quitting: Your heart rate drops and returns to normal.
12 hours after quitting: Carbon monoxide level in your blood drops to normal and blood oxygen increases.
2 weeks to 3 months after quitting: Your risk of a heart attack begins to drop. Your lung function begins to improve.
1 to 9 months after quitting: Your coughing and shortness of breath decrease.
1 year after quitting: Your added risk of coronary heart disease is cut in half.
2 to 5 years after quitting: Your risk of a stroke has returned to that of a nonsmoker. Your risk of cancers of the mouth, throat, esophagus and bladder is cut in half.
10 years after quitting: Your risk of developing lung cancer is cut in half compared to someone who continues to smoke. Your risk of cancers of the kidney and pancreas decreases.
15 years after quitting: Your risk of coronary heart disease is back to that of a nonsmoker’s risk.

The more attempts you make to quit, the more likely you are to quit. –Kimber Richter, PhD, MPH
Researcher, The University of Kansas Cancer Center

Cancer and quitting smoking: FAQ

It is never too late to quit smoking. People who quit smoking after a cancer diagnosis experience many benefits including a better response, fewer side effects and faster recovery from chemotherapy, radiation therapy and surgery.
Most smokers report using tobacco to cope with stress. However, smoking increases stress by causing frequent withdrawal periods throughout the day. Using tobacco relieves these symptoms, giving a false sense of stress reduction. Quitting smoking can be a challenge and nicotine withdrawal can be uncomfortable. There are medications and strategies to help make quitting easier and less stressful.
You may be able to quit cold turkey, but this could be more difficult. Using medications and support or counseling from your healthcare provider helps make quitting smoking easier. Plus, research shows that people who use these supports double or triple their chances of quitting and staying smoke-free.
If you have any form of health coverage you may be eligible for free or low-cost cessation medications. Most private insurance plans are required to pay for many if not all quit-smoking medications with no copay. Medicare Part D plans cover at least 1 form of prescription cessation medication. Kansas and Missouri Medicaid pay for all forms of quit-smoking medications with no lifetime limits or copay. If you have no insurance, the Pfizer pharmacy assistance program pays for varenicline, nicotine inhaler and nicotine nasal spray.
Medications don’t guarantee success the first time you try them. Like other medications, you must find the right combination that works for you. When you do, medications will reduce withdrawal symptoms (for example, irritability, weight gain, restlessness) and increase your ability to quit for good. People who were not successful with a medication in the past may still be successful with that medication in the future. You might also consider trying a medication you haven’t tried yet. Your healthcare team can help you choose the right medicine for you.
All FDA-approved medications for quitting tobacco are safe for most people to use even if they continue smoking. Those with a recent heart attack, severe arrhythmia or unstable angina should consult with their physician before starting their medications. The best plan is to stop smoking completely within the first few weeks of using these medications. Slips are a normal part of the quitting process for most tobacco users, so continue to use medications even if you slip.
Using nicotine replacement (NRT) is safe for most people. Check with your doctor about any specific health conditions you may have. Combining the nicotine patch along with either the nicotine gum, lozenge, inhaler or nasal spray is more effective than using NRT alone. Most people do not get enough nicotine when trying to quit tobacco. Combination NRT is one of the most effective ways to quit smoking.
Most of the harm from smoking is from the carbon monoxide, tar and thousands of chemicals in tobacco. These are not found in nicotine replacement (NRT) products. NRT replaces some of the nicotine your body receives from using tobacco, but in a safer form. Nicotine from NRT has few side effects.
Nicotine from nicotine replacement (NRT) is delivered to the body much more slowly and at lower levels than from smoking. As a result, the risk of becoming addicted to NRT is very small. All the tobacco medications should be used for about 12 weeks but can be used longer if needed.
Many people experience no side effects from varenicline. About 1 in 3 people have some nausea, which is why you should always take varenicline after a meal and with a full glass of water. Another side effect that affects about 1 in 3 people is vivid dreaming. Take the second dose earlier in the evening if you experience this. Most side effects are mild and go away after using the medication for several weeks. If you are worried about changes in mood or thoughts, talk with your healthcare provider.
There is no safe level of smoking. Those who smoke 4 or fewer cigarettes per day have 3 times the risk of dying from heart disease and 3 to 5 times the risk of dying from lung cancer compared to nonsmokers. However, you might find it helpful to cut down your tobacco use in order to prepare for quitting. Click here to learn how quitting tobacco can improve your cancer treatment success.
Quitting tobacco can be difficult, and it may take several attempts for your loved one to quit for good. Providing encouragement and supporting them through their quit attempts is an important part of their success. You can find more information on how to best help your loved one here.

Ready to give quitting a try?

Research shows that the best success for quitting tobacco is achieved by using both medication and support, such as counseling. Quitting is a process, so learning from slips and trying again is key to long-term success. Take the following 3 steps:

Step 1: Choose 1 or more medications and learn the best way to use them.

Medications can double to triple your chances of quitting smoking. There are 7 FDA-approved medications for quitting tobacco. The medication or medication combination which has been shown in clinical research to have the best quit rates is varenicline or combination nicotine replacement (NRT). Combination NRT means using the nicotine patch along with a short-acting NRT such as the nicotine gum, lozenge, inhaler or nasal spray.

Step 2: Choose your support.

Using behavioral support nearly doubles your chances of successfully quitting tobacco. Consider getting some type of extra support, like counseling, quit-coaching or participating in a text-messaging program.

Step 3: Most people try several times before they can quit for good. Slips are a normal part of the quitting process. If your plan is not working, try something different:

Add or change medications
Add or change supports
Try again

Not quite ready to quit?

Quitting tobacco can be difficult and it's normal to have mixed feelings about giving it up. Even if you aren’t quite ready to quit, there are some small steps you can take on the path toward quitting:

Make a list of what you would gain by quitting tobacco.
Decide how you would reward yourself for quitting.
Choose which quit-tobacco medication you will try first. All 7 FDA-approved medications can be used prior to a quit date to help you cut down your smoking.
Practice quitting by signing up for daily challenges using text messaging like the one offered by smokefree.gov.
Change your environment by limiting smoking to outside of the home and car. This will create a healthier living space and make it easier to quit when you are ready.
Consider quitting for others:
- Secondhand smoke is the smoke from a burning cigarette, cigar or pipe or the smoke that is breathed out while someone is smoking. It contains thousands of chemicals and toxic substances that increase a person’s risk of disease, including increasing risk of certain types of cancer and heart disease in adults and increasing risk of developing asthma, respiratory symptoms, ear infections and sudden infant death syndrome in children.
- Pregnant women, children, older adults and people with breathing conditions or heart disease are at an increased risk of developing health problems from secondhand smoke.

Vaping, electronic cigarettes and other tobacco

The rate of cigarette smoking has declined but the use of other forms of tobacco has increased in recent years. These tobacco products still contain harmful chemicals and toxins and are associated with various health risks and which could be linked to cancer. If you vape or use these other products, talk to your doctor about ways to quit.

Learn more about e-cigarettes and vaping from the CDC and the NIH.

How do I stop vaping or using e-cigarettes?

Find out tips on how to quit vaping at smokefree.gov or the Truth Initiative.

How do I stop using smokeless tobacco?

Find out how here.

Information for parents about kids vaping

What is JUUL?
Get the facts
Bench to Bedside
Vaping and e-cigarettes
JUUL and nicotine addiction
Four things parents need to know

Risks of e-cigarette use
Quick facts from the CDC
E-cigarettes and young people
From the U.S. Surgeon General

Resources to quit

If you or someone you know is ready to take the next step in quitting tobacco, here are some helpful resources.

Affording medication: Insurance coverage for medications is much better than you think.
- Nearly all private insurance plans cover all tobacco treatment medications.
- Medicaid in Kansas and Missouri cover all tobacco treatment medications for adults.
- If your insurance covers over-the-counter nicotine replacement (NRT), you will still need your doctor to provide a prescription in order for your prescription insurance to cover it.
- Varenicline, nicotine inhaler and nicotine nasal spray are all available through a pharmacy assistance program for those who meet income guidelines and are either uninsured or have prescription insurance that does not cover them. Call the Pfizer pharmacy assistance program at 1-844-98-PATH.
Quitline
- Provides free 1-on-1 coaching and other resources.
- Call 800-QUIT-NOW.
Text
- Text QUIT to 47848, or join at smokefree.gov.
- Text GO to 47848 to practice quitting.
Vaping and tobacco cessation program for teens:
- My Life My Quit
Community resources
- Turning Point

References

Fiore MC, Jaen, CR, Baker, TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

US Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.