Quitting smoking after cancer

It’s hard to quit smoking – especially after a cancer diagnosis.

“A lot of patients will use smoking as a self-medication for things like stress,” says Stephanie Snow, medical oncologist at the Nova Scotia Cancer Centre in Halifax.

“Being diagnosed with a cancer, going through cancer treatment, all of those things are very stressful. So patients often don’t feel this is the right time to undertake another very stressful process of quitting smoking.”

A new project by Cancer Care Nova Scotia aims to use volunteers to help patients quit smoking.

Cancer Care is a program of the Nova Scotia Department of Health and Wellness, which works with the government, health professionals and researchers to support the care of cancer patients and their families.

Leslie Hill, patient engagement coordinator at Cancer Care Nova Scotia, has a growing pile of applications from people who want to volunteer with the program.

“I can really see that this has touched a really positive nerve,” says Hill. “I have these amazing people calling me and emailing me every day telling me, ‘I want to be a part of this.’”

Volunteers will ideally be smokers or former smokers and have a personal connection with the cancer system, whether they have been diagnosed or have witnessed a family member, friend or partner undergo treatment.

Two volunteers will sit on an advisory committee and others will participate in surveys, workshops and focus groups to assist health professionals to keep cancer patients away from tobacco products during their treatment.

Hill says many applicants are long-time smokers who have had cancer and think their insight will help with the project.

A 2005 study by the Memorial Sloan-Kettering Cancer Center in New York states that almost 20 per cent of cancer survivors report being smokers, with 43 per cent younger than 40.

Snow says smoking interferes with the effectiveness of treatments such as radiation, chemotherapy and surgery. Patients who quit smoking have less chance of respiratory complications during a surgery.

For patients who are cured of their cancer, continuing to smoke increases their chances of a second diagnosis.

Snow says patients whose cancer is terminal often say, “If you can’t cure it and I’ve already got it, why would I want to quit smoking?”

“If there are cancers in the airways… you’re literally inhaling smoke directly onto the tumour,” says Snow.

“Continuing to smoke and having the direct exposure of the toxins could lead that cancer to develop new mutations and more aggressive or different behaviours.”

The American Cancer Society in Atlanta reported in 2014 that nine years after a cancer diagnosis, almost 10 per cent of survivors were smokers, and most were bladder, lung and ovarian cancer survivors. Many who quit had a smoking-related cancer.

Snow says it can often take multiple attempts for a patient to quit smoking.

Advisory committee meetings, including volunteers, will start in February, with a total of four meetings over the course of the project, which will wrap up in March 2017.