Northwestern University Feinberg School of Medicine
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Quitting Smoking after Cancer Clinical Practice Guidelines in Oncology for Smoking Cessation

Tobacco-related diseases are the most preventable cause of death worldwide; smoking cessation leads to improvement in cancer treatment outcomes, as well as decreased recurrence.  A recent report in JAMA Internal Medicine noted that smoking is responsible for almost half of all deaths from 12 smoking-related cancers.

To meet the needs of patients who are smokers at the time of a cancer diagnosis, the National Comprehensive Cancer Network® (NCCN®) has published the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Smoking Cessation.

Brian Hitsman, PhD is a member of the NCCN Guideline Panel for Smoking Cessation that recommends treatment plans for all smokers with cancer include the following: evidence-based pharmacotherapy, behavior therapy, and close follow-up with repeated treatment, as needed. “The guideline establishes an important standard of care for addressing nicotine dependence among the up to 30% of patients who continue to smoke following a cancer diagnosis,” said Hitsman, Assistant Professor of Preventive Medicine, Psychiatry and Behavioral Sciences at the Feinberg School of Medicine and a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “The lack of systematic and consistent procedures to monitor tobacco use among cancer patients and promote long-term smoking cessation has been a major gap in care.”

According to the NCCN Guidelines for Smoking Cessation, combining pharmacologic therapy, such as varenicline (Chantix) or nicotine replacement therapy, and counseling is the most effective treatment approach and leads to the best results in smoking cessation. Furthermore, smoking status should be documented in patient health records and updated at every visit; smoking relapse is common, and providers should discuss relapse and provide ongoing assistance for patients.

“Smoking cessation is a significant challenge for many individuals with cancer who would like to stop, but struggle to do so,” said Associate Director for Cooperative Groups, Al Benson III, MD, who represents the Lurie Cancer Center on the NCCN’s Board of Directors. “As a NCCN member institution, we wish to encourage our community to help patients obtain a healthier lifestyle as they manage the course of their cancer diagnosis. The NCCN Guidelines for Smoking Cessation represent one useful step to reach this goal.”

View the NCCN Clinical Practice Guidelines in Oncology

The NCCN Guidelines for Smoking Cessation joins a library of 10 additional NCCN Guidelines for Supportive Care, which comprise evidence-based treatment recommendations for supportive care areas including, but not limited to adult cancer pain, antiemesis, cancer- and treatment-related anemia and infections, fatigue, distress management, palliative care, and survivorship. NCCN publishes a full library of 61 clinical guidelines detailing sequential management decisions and interventions that currently apply to 97 percent of cancers affecting people in the United States, as well as cancer prevention, detection and risk reduction, and age-related recommendations. 

For more information about the NCCN and the NCCN Guidelines, visit

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