Smoking Doesn’t Just Cause Lung Cancer. It’s the Top Risk Factor For Bladder Cancer. Here’s How to Quit.

According to Dr. Andrea Tufano-Sugarman of NYU Langone Health, helping people with cancer quit smoking is similar to counseling other smokers, but there are several factors that make it more urgent. First, if patients can stop smoking, they will lower the chance of their cancer coming back. Second, smoking slows wound healing and tissue healing, which can be a problem for treatment and recovery. "When our patients are going in for a cancer surgery, there's really a fire under us to get them to stop smoking as soon as possible with any means necessary," says Dr. Tufano-Sugarman.

Wound healing is also important for people receiving and recovering from radiation treatment. Smoking can even make side effects of chemotherapy like fatigue and nausea more severe. On top of that, patients who are actively smoking cannot be given certain chemotherapies.

The point that Dr. Tufano-Sugarman stresses is that scientists know that smoking causes problems before, during, and after cancer treatment.

"We know that there is a causal relationship between smoking and both incidents of cancer, and the chance of dying from cancer," says Dr. Tufano-Sugarman. "And there are very few things in science that have a cause and effect relationship, but this is one of them, which is very powerful."

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When Dr. Tufano-Sugarman works with people with cancer to help them quit smoking, she typically combines behavioral therapy with pharmacologic therapy. Studies have shown that it is helpful for a doctor to give patients advice and explain the risk of smoking, but "it doesn't compare at all to the huge gains of them going to someone who is actually trained in this area," says Dr. Tufano-Sugarman.

Counseling is often paired with nicotine replacement therapy. Dr. Tufano-Sugarman typically prescribes a daily nicotine patch to manage withdrawal symptoms, as well as a fast-acting option to curb cravings like a nicotine gum, inhaler, or spray.

Dr. Tufano-Sugarman wants people with cancer to know that the process of quitting smoking is not always linear. "There's going to be slip-ups and relapses," she says. But above all, Dr. Tufano-Sugarman says, "It's never too late to stop."

Strategies for Managing Tobacco Cravings

1. Nicotine replacement therapy. As Dr. Tufano-Sugarman discussed, nicotine replacement therapy is one of the main tools that smokers have at their disposal. Long-acting therapies like nicotine patches can be paired with short acting therapies (including nicotine gum, lozenges, nasal spray, and inhalers) to cope with intense cravings. More research will be needed to gauge the effectiveness of other smoking substitutes like e-cigarettes and vapes.
2. Steer clear of triggers. Cravings can be provoked by situations that you are used to having tobacco in. It can help to familiarize yourself with these environments and make plans for how you can manage them without tobacco or how you can avoid them completely.
3. Wait. If you feel yourself on the brink of giving in to a tobacco craving, delay smoking for 10 minutes and do something else to distract yourself. Move to a no-smoking area to make it less convenient for you to smoke. Cravings can often subside if given time.
4. Chew something. Whether it's gum, candy, or vegetables, chew something that will occupy your mouth as you resist your cravings.
5. Don't give in to the "just one more" mentality. Smoking once just leads to smoking again. Be careful not to convince yourself that you can satisfy a tobacco craving and then quit after that.
6. Exercise more. Boosting your physical activity can distract you from tobacco cravings and also make them less intense. Exercise can mean a lot of different thingseven short periods of physical activity can help tobacco cravings go away.
7. Try relaxation techniques. Finding new ways of dealing with stress can be an important part of quitting smoking. Techniques like deep-breathing, yoga, visualization, muscle relaxation, and massage can open new doors for the way you relate to stress and smoking.
8. Reach out for support. Establishing strong support systems is essential both for people battling cancer and people battling tobacco addiction. Calling a friend or family member to talk on the phone or go for a walk can help remind you that you're not in this alone.
9. Research other resources. The Mayo Clinic recommends a free telephone line800-QUIT-NOW (800-784-8669)for support and counseling. Additionally, there are online support groups for smokers trying to quit, and blogs where people write about how they manage the same challenges you are facing.
10. Remind yourself why you want to quit. Whether your goal is to feel better, get healthier, save money, or prepare for cancer treatment, it can help to write down or speak aloud the reason you decided to quit in the first place.

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