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The Great American Smokeout is a national program held each November by the American Cancer Society to encourage people to quit tobacco. The Rogel Cancer Center supports this effort.
Quitting smoking any day of the year can greatly reduce your risk of cancer and cancer recurrence. We sat down with Alena Williams, MSW, a Michigan Medicine health educator, tobacco treatment specialist and clinical group facilitator at the Cancer Support Community of Greater Ann Arbor, to discuss the Tobacco Consultation Service that’s available to all patients at the cancer center and why quitting tobacco is so important to the health of patients and survivors.
What is it about tobacco that causes cancer?
The link between smoking and cancer is very well established. We know that one out of every three cancer deaths in the United States is linked to smoking, and while lung cancer was the first cancer to be identified as having this causal relationship with smoking, we know that there are actually 16 different cancers that are caused by smoking, including cancer of the stomach, pancreas, colon, cervix, kidney and liver.
This tobacco/cancer link is the result of tobacco smoke’s damaging effect on every organ in the body. Tobacco smoke contains 7,000 chemicals with at least 70 known to cause cancer. The damage comes from directly inhaling smoke or indirect exposure from second- and third-hand smoke.
How does using tobacco impact cancer treatment outcomes?
Evidence shows that continuing to smoke tobacco after a cancer diagnosis increases the risk of a new primary cancer, cancer recurrence and adverse side effects from cancer treatment. Smoking also increases post-treatment mortality. Quitting smoking has significant health benefits and is one of the most important changes to make after a cancer diagnosis. Quitting is associated with decreased risk of disease recurrence, secondary cancers, treatment side effects and complications. Quitting is also linked to improvements in treatment response and effectiveness and overall improves survival.
Can you talk about the stigma of cancers related to smoking, especially lung cancer?
I have a personal and professional connection to smoking-related cancers. I see the damaging and deadly impact every day working with patients living with cancer. Most people who smoke really want to quit and are making attempts to quit without support. They might not know that the use of evidence-based tobacco treatment can double a person’s chances of successfully quitting.
On a more personal note, my mother was diagnosed with stage 4 lung cancer and died from the disease at age 50. After her diagnosis, she was urged to quit by her health care providers but was never provided with support on how to stop. Smoking had been a part of her everyday life for 30 years.
When patients talk about stigma, I say that tobacco use is an addiction; nicotine creates biochemical changes in the brain that make it extremely difficult to quit, even after a cancer diagnosis. Nicotine addiction should be addressed like any other addition, with support to manage the psychological addiction.
What about smokeless tobacco? Is that healthier than cigarettes?
Smokeless tobacco like chew tobacco, snuff and snus is still tobacco, which provides nicotine along with other substances that are known to cause cancer. While the tobacco is not inhaled into the lungs, it is still being absorbed through the lining of the mouth and circulates through the bloodstream to all parts of the body.
Use of smokeless tobacco has been linked to oral cancer, esophageal cancer and pancreatic cancer. It can also cause heart disease, gum disease and oral lesions known as leukoplakia.
Q: And what about vaping? Are electronic cigarettes safe?
E-cigarettes and vapes can contain harmful or potentially harmful substances, including heavy metals (like lead), volatile organic compounds and cancer-causing chemicals. The use of these products has been shown to cause severe lung disease and even death. Concern over the health impact of these products has prompted the Centers for Disease Control and Prevention to urge people to stop using flavored e-cigarettes pending investigation.
What resources are available for patients who want to quit smoking?
The Tobacco Consultation Service, or TCS, is available for free to anyone interested in quitting. We provide inpatient consultation for hospitalized patients to manage nicotine withdrawal symptoms, help with a quit plan and a six-week outpatient program that covers preparing to quit and living a tobacco-free life. There is a telephone option to make our program more accessible to people who may not live near Ann Arbor. We focus on setting reasonable goals, nicotine replacement therapy, finding people in your life to offer support or encouragement and other aspects to ensure your success.
For people looking to quit, we recommend the use of one of the seven FDA approved medications to support cessation. These medications include the nicotine patch, nicotine gum, nicotine lozenge, nicotine inhaler, nicotine spray, varenicline (Chantix) and bupropion (Wellbutrin). These products are well researched, safe and effective.
Our website offers a Tobacco Treatment Virtual Quit Kit that is also helpful. It contains a guide to quitting smoking, what to do instead of tobacco, information on tobacco quit aids and even a recipe to make cinnamon-flavored toothpicks, which can be a great tool when quitting.
Is there anything else you want patients to know about TCS?
TCS is extreme happy to be working with the Rogel Cancer Center on the Cancer Center Cessation Initiative, also called C3I, to expand tobacco treatment programming. The C3I is a nationwide effort to help people who are undergoing treatment for cancer quit smoking. It is part of the National Cancer Institute’s Cancer Moonshot.
Continue reading the Fall, 2019 issue of Thrive
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