IASLC: All physicians should screen patients with cancer for tobacco use
BARCELONA — The International Association for the Study of Lung Cancer, or IASLC, today issued a declaration at its World Conference on Lung Cancer advising all physicians to screen their patients with cancer for tobacco use and recommend tobacco cessation.
“Everybody knows that tobacco is the main cause of lung cancer and other malignancies, as well as a leading contributor to other diseases, like heart disease,” Jacek Jassem, MD, PhD, full professor of clinical oncology and radiotherapy and head of the department of oncology and radiotherapy at Medical University of Gdansk in Poland, said during a press conference. “But the problem of whether smoking after diagnosis is harmful is not addressed. That is why the IASLC Tobacco Control and Smoking Cessation Committee developed our declaration addressing this problem.”
The declaration aims to draw attention to the importance of tobacco cessation after a cancer diagnosis, as patients who continue to smoke after diagnosis are at increased risk for mortality and second cancers.
Patients with cancer who continue to smoke also may face increased treatment costs due to complications and greater toxicity from cancer treatment.
“For too long this has been a neglected problem in the education of health professionals,” Jassem said in a press release. “Many physicians still believe that it is too late to offer smoking cessation support at cancer diagnosis. Likewise, most patients believe that there is nothing to be gained from quitting once being diagnosed.”
Surveys of IASLC members have shown that 90% of health care professionals ask about tobacco use and 80% advise patients to quit smoking, but few offer assistance with quitting.
The declaration describes a cancer diagnosis as a “teachable moment” wherein oncologists can engage in shared decision-making with their patients about quitting smoking, at a time when patients may be more likely to quit with assistance.
“In our opinion is that there should be an enhanced focus on smoking cessation at the time of a cancer diagnosis, and active intervention may increase patients’ action to quit,” Jassem said during the press conference.
The declaration’s recommendations include that:
- all patients with cancer be screened for tobacco use and receive information about the benefits of tobacco cessation;
- multidisciplinary care include routine evidence-based tobacco cessation assistance for patients who continue to smoke and their family members;
- tobacco cessation training be part of education programs on cancer management, with an emphasis on empathetic communication regarding tobacco use and reliance on existing evidence-based cessation resources;
- counseling and treatment for smoking cessation be reimbursable;
- all prospective clinical trials require patients to report smoking status; and
- oncology clinical trials consider designs that incorporate analysis of effective tobacco cessation interventions.
“IASLC is a clinical organization, but we are also focused on cancer prevention,” Jassem said. “Our committee is very active in this area, we have many undertakings, publications and scientific work, with this declaration just being one example, to encourage an antitobacco policy all over the world.” – by Alexandra Todak
For more information:
IASLC. Declaration from IASLC: Tobacco Cessation After Cancer Diagnosis. Available at: www.iaslc.org/About-IASLC/News-Detail/declaration-from-iaslc-tobacco-cessation-after-cancer-diagnosis. Accessed on Sept. 6, 2019.