论文部分内容阅读
Tobacco use increases the risk for many cancers, including lung, head and neck, esophagus, colorectal, non-melanoma skin, pancreas, kidney, bladder, and uterine cervix.Quitting smoking after a cancer diagnosis decreases the number and severity of complications as well as risk for rumor progression and the development of a second primary cancer.Patients with cancer who stop smoking have improved survival and quality of life; this relationship holds true even for late-stage cancer patients.Despite the benefits to be gained from smoking cessation after a cancer diagnosis, a substantial proportion of patients with cancer continue to smoke.Nicotine addiction is a key factor in persistence of cigarette smoking among these patients.Although this addiction is difficult to overcome and this habit is hard to change, supportive counseling in conjunction with pharmacotherapy such as nicotine replacement therapy (NRT) is effective in promoting cessation among these patients.Unfortunately, effective smoking cessation aids such as counseling and NRT are generally underutilized and there is much room for improvement to increase the reach of existing evidenced based smoking cessation practices for patients with cancer.Many physicians are reluctant to encourage their very ill patients to stop smoking for fear of increasing both the patients guilt about their addiction and stress regarding their illness.However, by preempting the inherent difficulty of promoting smoking cessation, practitioners are telling their patients, "I have an intervention that will make your treatment work better and increase your survival time, but I think it would be too difficult for you, so lets not discuss it." Aggressive smoking cessation treatment that involves a strong physician endorsement to try quitting and offering counseling plus pharmacotherapy should be offered for all patients, even those with end-stage disease having weeks or months to live.When a patient is successful in smoking cessation, recent research suggests his/her quitting smoking can be contagious and have an impact on family and friends.One persons smoking behavior change can have a public health impact by encouraging others to quit smoking and reducing environmental tobacco smoke.