EXPERT VOICES

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American Cancer Society Expert Voices

The American Cancer Society

Tobacco/Smoking (16 posts)  RSS

Continuing to smoke after a cancer diagnosis

November 17, 2014

By J. Lee Westmaas, PhD


While the American Cancer Society and other organizations traditionally focus on getting smokers to quit before they develop cancer, there's a group of smokers who are especially susceptible to the negative effects of smoking. They are cancer survivors - some of whom have been diagnosed with a smoking-related cancer. It's easy to say, "If you get cancer, then you should know better and quit, and stay quit," but that's not the whole story.

Getting a cancer diagnosis does motivate some smokers to quit. Using data from the American Cancer Society Cancer Prevention Study-II, we found that about 1 out of 3 smokers quit smoking when they were diagnosed with cancer. That compares with only 1 out of 5 smokers who quit but were not diagnosed with cancer during the same time periods studied.

Even smokers whose cancer was not strongly linked to smoking (like breast cancer) quit at higher rates than undiagnosed smokers. These results were not caused by the smokers being unable to smoke due to their illness; those people were excluded from the study.

Smoking: Risky for patients and survivors

Quitting is particularly important for cancer patients and survivors because smoking can increase the likelihood of a recurrence, delay wound healing, and make cancer treatments less effective. This is true even for cancers that aren't related to smoking. 

Unfortunately, there are some cancer survivors who find it very hard to quit. We looked at data from the Study of Cancer Survivors (SCS-I), a nationwide quality-of-life study conducted by the Behavioral Research Center at the American Cancer Society. The study surveyed 2,938 survivors of 10 different kinds of cancers approximately 9 years after their initial diagnosis.

We found that 9.3% of these survivors were current smokers. Survivors of bladder, lung, and ovarian cancers had the highest smoking rates in this study. Most (83%) current smokers smoked daily, averaging almost 15 cigarettes per day. In fact, 40% percent of daily smokers smoked more than 15 cigarettes per day. More...

Are lung cancer breath tests more than hot air?

November 10, 2014

By Ted Gansler, MD, MBA, MPH

Can breath tests (like those used to check whether drivers have been drinking alcohol) be used for lung cancer screening? Or, is this (pardon the pun) just a lot of "hot air?" Although breath tests for lung cancer are "not ready for prime time," there has been some encouraging research.

There are 3 main ways to fight cancer - prevention, screening, and treatment. Although lung cancer remains the leading cause of death from cancer worldwide and in the United States, researchers are making progress against this disease on all 3 fronts. 

Over nearly a half century, researchers tried several tests for lung cancer screening, none of which were accurate enough for widespread use. Because of research results released in 2010, the American Cancer Society and several other organizations now recommend that people at high risk for lung cancer (certain groups of current and former smokers) ask their doctor about CT scans for lung cancer screening.

On average, people in these high risk groups who have this test every year according to the ACS guidelines can reduce their risk of dying from lung cancer by about 20%. This can save a lot of lives and prevent a lot of suffering, so if you are a current or former smoker, you should read more about our lung cancer screening recommendations.

Research into easier lung cancer screening

One challenge with CT scans is that they find some lung nodules that are neither clearly cancer nor clearly benign (not cancer). This question is usually figured out by follow-up scans, but sometimes biopsies are needed. These biopsies can pose significant risks, which is one reason screening isn't recommended for people whose risk of lung cancer isn't as high as that of heavy smokers. So researchers are looking for ways to make screening easier and more accurate, faster and more affordable. More...

Can we predict who will become addicted to cigarettes?

July 24, 2014

By Victoria Stevens, PhD

Every day in the United States, nearly 4,000 young people under the age of 18 smoke their first cigarette, according to the Centers for Disease Control's Youth and Tobacco Use Fact Sheet. About 1,000 of these kids will go on to become daily smokers, which is the next step on the pathway to becoming addicted to nicotine. Over the course of a year, that is 365,000 new daily smokers. About 60%, or almost 220,000, will still be regular smokers 7 to 9 years later. 

When they tried that first cigarette, did they expect to become dependent on nicotine and unable to quit smoking whenever they want to? Of course not, because they feel young and invincible. In fact, only 3% of the regular smokers expected to be still smoking 5 years later. 

Is nicotine addiction in our genes?

A paper published in JAMA Psychiatry may give some clues to why so many young people continue smoking after that first try. Please note: the research is preliminary, and much more needs to be done before any conclusions are reached and recommendations made. But it's also intriguing. More...

E-Cigarettes – It’s Complicated

June 24, 2014

By Thomas J. Glynn, PhD

Editor's note: This blog is the last one frequent contributor Dr. Glynn will write before his upcoming retirement. We wanted to thank him for his expertise and ability to break down a topic and offer insight, as well as his excellent writing. We offer him best wishes for a long, happy retirement.


In May 2011, I had the opportunity to write the first Expert Voices blog on what was then a new, but growing, public health concern - the emergence of e-cigarettes.

At that time, I wrote that "e-cigarettes have been described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health;" that they "are a source of controversy;" and that we need "to put science to work (and) obtain, solid, independent data" regarding e-cigarettes.

Now, 3 years later, more than 1,000 research papers, commentaries, and opinion pieces have been published about e-cigarettes. There's been continuous public debate about and media attention paid to e-cigarettes, and there's a proposed FDA rule regarding e-cigarette regulation.

Now, it is finally possible, at long last, to say that... e-cigarettes continue to be described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health; that they remain a source of controversy; and that more independent, objective data are needed.

Consensus remains elusive

Yes, the old French adage - plus ca change, plus c'est  la meme chose  (the more things change, the more they remain the same)-- is an apt description for the state of affairs regarding e-cigarettes in June 2014. Despite the considerable research, debate, media attention, Congressional hearings, and, yes, blogs, over the past 3 years, the public health, advocacy, scientific, and medical communities are little closer to a consensus regarding e-cigarettes than they were in May 2011. More...

The Landmark Surgeon General Report on Smoking and Health, 50 Years Later

January 15, 2014

By Richard C. Wender, MD

 

Fifty years ago, on January 11, 1964, Luther Terry held a press conference to announce the results of the first Surgeon General's report on smoking and health, the most impactful public health document in history. The report laid to rest over a decade of debate about the health risks of smoking by definitively stating that smoking causes lung and laryngeal cancer in men, chronic bronchitis, and other diseases.

Research conducted by the American Cancer Society and other groups had already demonstrated the adverse health effects of smoking, but, until the Surgeon General's report, the tobacco industry had been successful in hiding the truth. The extraordinary methods used by the Surgeon General to ensure that the report was completely unbiased -- including allowing the tobacco industry to veto nominees to serve on the panel -- the thoroughness of the research, and the clarity of the conclusions, all led to one outcome: the end of the debate about the health risks of smoking and the launch of the true fight to end the use of tobacco products. The progress in the tobacco fight over the past 50 years represents one of the most successful, life-saving public health campaigns in our nation's history.

Learn more about the 50th anniversary of the Surgeon General's Report on Smoking and Health:

The Hammond/Horn study

The effects of tobacco control

Rates Drop for New Lung Cancer Cases in the US

Tobacco and Cancer

Guide to Quitting Smoking

 

The public health victories, and the challenges



Forty-three percent of Americans smoked prior to the Surgeon General's report; 18% smoke today. Smoking in airplanes, restaurants, and places of employment has largely disappeared.  We're now fully aware of the addictive nature of the nicotine in tobacco products, and the importance of preventing and treating that addiction. Tobacco executives were eventually forced to admit, before Congress and the country, that they were long aware of the addictive nature of their products as well as the harmful health effects. 

We've learned that raising the cost of a pack of cigarettes is the single most effective way to reduce the number of people who start using tobacco products and the most effective way to promote quitting. Tobacco tax increases have been implemented in many states.  As of 2009, the FDA was granted the authority to regulate tobacco products, although the tobacco industry has placed substantial roadblocks in the path of effective FDA action. The United States is not alone. Smoking rates in most high-resource ("Western") nations like England, Canada, and Australia have substantially declined, comparable to the progress that we've seen.  We've witnessed 50 years of amazing progress; we truly do have much to celebrate.  

And much to lament. More...

Filed Under:

Tobacco/Smoking

What really works to help you quit and avoid tobacco?

November 17, 2013

By Thomas J. Glynn, PhD


The American Cancer Society's first Great American Smokeout was celebrated November 18, 1976. Gerald R. Ford was President of the United States, the "War on Cancer" had begun just a few years before, Barack Obama was 15 years old and, according to a Gallup Poll taken that year, 37% of American adults smoked cigarettes.

This year, the 37th anniversary of that first Great American Smokeout, the percentage of Americans who smoke has nearly been cut in half, to 19%. And, those who do smoke use far fewer cigarettes than in 1976, from about 4,000 cigarettes per year for every U.S. adult then, to about 1,200 now.

Certainly, we know that any cigarette smoking is dangerous to the smoker and non-smokers who inhale cigarette smoke. We also know that far too many Americans continue to smoke - 44 million, at last count. Still, astounding progress has been made in combatting what is the nation's largest cause of preventable death and disability.

How do we know what works?

How was such progress made? What actions were taken to achieve such significant changes in the face of the tobacco industry's relentless, illegal, and well-funded efforts to addict men, women, and children to their deadly products? There is no easy answer to that question. But we do know that, over the past 37 years, a wide range of interventions - in communications, education, policy change, and medicine - have been undertaken. Interventions in all of these areas have been effective, but some have been more effective than others. More...

Menthol cigarettes - what's the big deal ?

August 28, 2013

By Thomas J. Glynn, PhD


The discussion around whether the U.S. Food and Drug Administration (FDA) should keep or ban menthol-flavored cigarettes has produced a number of news headlines in recent weeks, because in July the agency released a report reviewing current science around these cigarettes. This science will inform many of the decisions the agency may make about menthol cigarettes, and the millions of current and potential smokers who will be affected by those decisions. But the menthol story goes back much further than just the past few weeks.

Menthol and cigarettes: a brief history


Menthol is an organic compound which can be made in a laboratory or derived from mint oils, and has a distinctive and, for most people, pleasant odor and taste. It is used to enhance the flavor, popularity, and ease-of-use of many food products, candies, and medications.

As a medication, it can be used as a mild local anesthetic, counter-irritant, and, more specifically, for the relief of minor throat irritation. That is why menthol was first introduced in cigarettes in the 1920's and gained broader popularity with the introduction of a filtered menthol brand, Salem, in the mid-1950's.

Over the years, largely because they mask the harsh taste and/or throat-irritating properties of inhaled tobacco smoke, mentholated cigarettes have gained a wide audience, such that about 30% of all 44 million smokers in the U.S. now identify menthols as their preferred cigarette. This is especially true among African American smokers, about 80% of whom are menthol users. More...

Light smoking as risky as a pack a day?

January 02, 2013

By J. Lee Westmaas, PhD


Do you occasionally have a cigarette, maybe not even every day? Although people resolve to quit smoking in the new year, you might think only heavy smokers need to quit. But that isn't the case.

Light or intermittent smoking has become a very common pattern for people of any age.  Many of these people do not feel addicted to tobacco and do not even call themselves "smokers." There are, however, some real risks associated with any level of smoking. Non-daily smoking, or smoking 1-5 cigarettes a day, was first noticed as far back as 1989 because it was a stark contrast to the more common pattern at that time -- 20 to 30 cigarettes a day. At that time, very light smokers were labeled "chippers" (a term that also referred to occasional users of opiates who appeared to not be addicted). Chippers didn't appear to smoke to relieve withdrawal, and sometimes didn't smoke for a day or more. More...

Mind the (Smoking) Gap: Those Who Want to Quit and Those Who Actually Do

November 14, 2012

By Thomas J. Glynn, PhD


For those who have traveled London's Underground, or Tube, the term "Mind the Gap" will be familiar. It's the warning for riders to be aware that there is a gap of several inches between the station platform and the train cars. In the public health community, we also have a gap: the gap between the number of smokers who want to quit and those who actually succeed. The American Cancer Society Great American Smokeout, held this year on November 15, is an opportunity to remind us that we also need to "mind the gap."

In the United States, this gap is very wide. Nearly 70% of the country's 43.8 million smokers say they would like to quit smoking; 52% report making at least one serious attempt to quit each year; but a disappointingly low 4% are actually successful in doing so. More...

The FDA and Tobacco Regulation Three Years Later

October 29, 2012

By Thomas J. Glynn, PhD

 

As the official sponsor of birthdays, the American Cancer Society has every reason to be proud of a "toddler" celebrating its third birthday this year. The Family Smoking Prevention and Tobacco Control Act - aka the Tobacco Control Act - was strongly supported by ACS and ACS CAN and signed into law by President Barack Obama on June 22, 2009.


For the first time and after nearly 2 decades of debate, this historic legislation gave the U.S. Food and Drug Administration (FDA) the authority to regulate tobacco products. In doing so, Congress enabled the FDA to establish the Center for Tobacco Products (CTP), which is charged with regulating the manufacture, marketing, and distribution of tobacco products in order to reduce tobacco use by children under 18 and protect public health.


More specifically, the Tobacco Control Act authorizes the FDA to act in a number of ways, including:

  • Restricting tobacco sales, distribution, and marketing
  • Requiring stronger health warnings on packaging and in advertisements
  • Requiring disclosure of tobacco product ingredients
  • Reducing (but not eliminating) the amount of nicotine in tobacco products
  • Creating standards for tobacco products
  • Regulating "modified risk" (i.e. potentially harm reducing) tobacco products, such as e-cigarettes, snus, dissolvables, etc.


So, with the authority to take these types of action, how is the Tobacco Control Act doing 3 years later? Is it having its intended effects? Are Americans - tobacco users and non-users alike - beginning to see its hoped-for health benefits? To best address these questions, it will help to take a small step back and consider the history of the Tobacco Control Act, take a brief look at the Act's accomplishments to date, and then look a bit into the future. More...

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