JUN 26, 2023 3:00 AM PDT

Quitting Smoking After Cancer Diagnosis Reduces Risk of Cardiovascular Events

WRITTEN BY: Katie Kokolus

Recent advances in cancer diagnosis, treatment, and management have resulted in a growing number of cancer survivors.  Researchers constantly strive to understand new ways to support cancer survivors and help them lead a healthy and happy life post-treatment.  This has led to our understanding that cancer survivors have different healthcare needs than their counterparts with no history of cancer. 

One concern facing cancer survivors involves cardiovascular disease (CVD), a general term including conditions that inflict the heart or blood vessels.  Many cancer survivors face a higher risk of dying from cardiovascular disease (CVD) than from cancer itself. 

Despite the well-known adverse effects of tobacco use associated with both cancer and CVD, about 20% of cancer survivors continue smoking after diagnosis.  How smoking cessation impacts CVD risk after cancer diagnosis remains poorly understood.  To address this, a team of researchers recently published their study investigating the cardiovascular consequences of quitting smoking after a cancer diagnosis in the European Heart Journal

The researchers obtained data from the Korean National Health Insurance Service on 1,246,958 adults diagnosed with cancer between 2006 – 2013.  About 850,000 individuals achieved three-year survival, and about 320,000 survivors received health exams within the two years prior and three years after cancer diagnosis.  The researchers identified a final cohort of 309,095 cancer survivors (average age 59 years) without a history of CVD. 

The researchers assessed smoking habits using a self-reported questionnaire during the health exams and divided the patients into four groups:

  1. “Sustained non-smokers” (non-smoker before and after diagnosis)
  2. “Quitters” (smoker before diagnosis and non-smoker after diagnosis)
  3. “Initiators/relapsers” (non-smoker before diagnosis and smoker after diagnosis)
  4. “Continuing smoking” (smoker before and after diagnosis)

On average, pre-diagnosis health exams occurred six months before and two years after diagnosis. 

The cohort included 80.9% sustained non-smokers, 10.1% quitters, 1.5% imitators/relapsers, and 7.5% continuing smokers.  Interestingly, changes in smoking habits varied among cancer types.  Proportions of initiators/relapsers and continuing smokers were highest among urinary tract, male genital organ, and gastrointestinal (including pancreas) cancer survivors.  On the other hand, the lowest proportions of initiators/relapsers and continuing smokers were seen among breast, female genital organ, endocrine, and lung cancer survivors. 

The researchers identified 10,255 CVD events that occurred post-diagnosis.  CVD events most commonly occurred in continuing smokers and least commonly in sustained non-smokers.  Notably, CVD events occurred less often in quitters than continuing smokers or initiators/relapsers. 

These findings indicate that quitting smoking post-cancer diagnosis can reduce the risk of experiencing a CVD event.  Identifying cancer-type variability in smoking habit changes after cancer diagnosis also suggests a need to develop different educational strategies for smoking cessation based on cancer.  Further, since over 40% of smokers on the study continued smoking after diagnosis, the authors suggest the need for extra efforts to encourage newly diagnosed cancer patients to quit smoking. 


Sources: Eur Heart J (Sturgeon), CA, Nicotine Tobacco Res, Eur Heart J (Lee)

About the Author
Doctorate (PhD)
I received a PhD in Tumor Immunology from SUNY Buffalo and BS and MS degrees from Duquesne University. I also completed a postdoc fellowship at the Penn State College of Medicine. I am interested in developing novel strategies to improve the efficacy of immunotherapies used to extend cancer survivorship.
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