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Special populations: People who smoke
Cigarette smoking is an important public health issue that causes more than 480,000 deaths annually. Smoking increases the risk of many diseases, from heart disease to stroke. This research indicates that smoking before and or after a diagnosis of breast cancer affects survival, and also shows that it is never too late to quit smoking.
How cigarette smoking before and/or after a diagnosis of breast cancer affects breast cancer survival and other smoking-related diseases.
While experts may not have enough evidence to confirm a direct relationship between smoking and breast cancer, the 2014 Report of the Surgeon General on the health consequences of smoking suggested that smoking may cause breast cancer. Beyond the risk of breast cancer, cigarette smoking is an important public health issue. It increases the risk of heart disease, stroke, lung cancer, overall diminished health, and causes more than 480,000 deaths in the U.S. each year.
While no studies directly implicate cigarette smoking as a cause of breast cancer, this study found that smoking appears to affect breast cancer mortality. Researchers saw a benefit for women who quit smoking after their breast cancer diagnosis; that is promising, showing that quitting smoking, even later rather than sooner, can improve health.
Additionally, cigarette smoking has harmful health effects throughout the body. Women and men who smoke should get whatever help they need to quit.
Oncology Nurse Advisor
The Sacramento Bee
Previous research linked cigarette smoking before breast cancer diagnosis to lower breast cancer survival but little is known about how smoking after a breast cancer diagnosis affects breast cancer survival.
In January 2016, Michael Passarelli and colleagues from the University of California, San Francisco and other institutions published a study in the Journal of Clinical Oncology about how smoking before and after a breast cancer diagnosis affects breast cancer survival.
Whether an association exists between breast cancer survival and smoking before or after a diagnosis of breast cancer.
About 21,000 women from the Collaborative Breast Cancer Study (CBCS) participated in this study and:
The women were asked several key questions about smoking: whether they had smoked at least 100 cigarettes during their lifetime, when they started, how long they had been smoking, the average number of cigarettes they smoked each day, whether they had smoked one year before they were diagnosed with breast cancer, if they currently smoked, and (for the women who had quit) the age they quit.
About 15,000 women from the CBCS study were invited to participate in the Collaborative Women’s Longevity Study (CWLS). The women who completed the survey were all breast cancer survivors and were an average of 6 years post-breast cancer diagnosis. This questionnaire asked the women for information about their post-diagnosis exposures and health events.
Conducting a study based on responses from a self-reported questionnaire has limitations. It is possible that some women may not have accurately presented their smoking status. The study design allowed only one opportunity to follow up with the smoking status of women after diagnosis; because the study represents only a snapshot, it may not have been entirely accurate.
Nor did this study take into account the hormone receptor status of breast tumors, or whether or not women had a mutation in BRCA or another gene that increases cancer risk; whether these factors combined with smoking affect breast cancer survival—and to what extent—is unknown.
This research provides evidence that smoking affects breast cancer survival before and after a breast cancer diagnosis, and showing that quitting after breast cancer diagnosis has benefits. However, according to the study authors, “Regardless of a diagnosis of breast cancer, smokers should undergo recommended respiratory and cardiovascular disease surveillance to reduce smoking-related survival.”
CDC Fact Sheet: Health Effects of Cigarette Smoking
Passarelli MN, Newcomb, PA, Hampton JM, et al. “Cigarette Smoking Before and After Breast Cancer Diagnosis: Mortality From Breast Cancer and Smoking-Related Diseases.” Journal of Clinical Oncology. Published online first on January 25, 2016.