Health professionals needed to help cancer patients quit smoking

Apr 30 2018

Survey of oncologists highlights evidence-practice gap in smoking cessation care

Quit smoking

An Australian-first study led by researchers from the University of Newcastle, the Hunter Medical Research Institute (HMRI) and the Hunter Cancer Research Alliance has shown that oncologists can do more to support cancer patients to quit smoking.

In collaboration with the Cancer Institute of NSW and Cancer Council NSW, the research team conducted a survey of nearly 700 Australian medical and radiation oncologists to find out more about current clinical practices, preferences and barriers in helping patients quit smoking.

“We found that almost all oncologists bring smoking up in their first consultation with a patient, but only half of them regularly ask about smoking in follow-up consultations. Few (<20%) regularly provide support in the form of referrals and pharmacotherapy,” said lead authors Dr Fiona Day and Professor Christine Paul.

The harms of smoking during cancer treatment are severe.

“Continued smoking in cancer patients affects treatment efficacy and overall survival,” said Professor Sanchia Aranda, CEO at Cancer Council Australia.  

“Cancer patients who smoke are also at risk of treatment complications and higher hospitalisation rates during cancer treatment, a greater likelihood of cancer recurrence, and significantly lower survival rates, so it’s really important that the health system supports them in kicking the habit to achieve better outcomes,” Professor Aranda added.

The research also found that oncologists strongly prefer smoking cessation interventions to be managed by other health workers.

Professor David Currow, Chief Cancer Officer and CEO of the Cancer Institute NSW, which funded the study, said that emerging evidence continued to confirm that supporting patients undergoing cancer treatment to quit smoking improved their overall outcomes.

“In the past there was a view that once a person was diagnosed with cancer, quitting was not a priority. We now know that quitting smoking even after a cancer diagnosis can have a huge impact on treatment,” said Professor Currow. “Smoking cessation is now an essential part of cancer care. The Cancer Institute NSW is working closely with cancer services across NSW on a project to embed smoking cessation brief interventions into all cancer services.”

The researchers suggest a team approach to cessation care where oncologists may be the first to engage with the patient about the need for quitting, e.g. providing motivational advice and information about the benefits, and putting together an agreed plan with the patient on the best referral and support strategy.

“This should be followed by engagement with adequately resourced, accessible health professionals, such as the NSW Quitline, who understand both cancer treatment and smoking cessation. Follow-up on the patient’s progress by the oncologist would provide continuity and may aid in preventing relapse,” Dr Day and Professor Paul concluded.

If you’re a smoker, call 13 QUIT or visit for advice and support on quitting.