NCCN Publishes New Guidelines for Smoking Cessation

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Peter G. Shields, MD

Robert W. Carlson, MD

Tobacco-related diseases are the most preventable cause of death worldwide. According to the American Cancer Society, in 2015, nearly 171,000 of the estimated 589,430 cancer deaths in the United States—more than 25%—will be caused by tobacco smoking. Smoking cessation leads to improvement in cancer treatment outcomes, as well as decreased recurrence.

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. The NCCN Guidelines for Smoking Cessation were presented on March 13, 2015, at the NCCN 20th Annual Conference.

The NCCN Guidelines Panel for Smoking Cessation, chaired by Peter G. Shields, MD, recommends that treatment plans for all smokers with cancer include the following: evidence-based pharmacotherapy, behavior therapy, and close follow-up with retreatment, as needed.

More Patient Support Needed

“Smoking addiction is a chronic, relapsing disease, and many factors contribute to a person’s success or failure to kick the habit long term. Science has shown us that smokers with cancer have a high level of dependence, and smoking cessation leads to improvement in cancer treatment effectiveness and decreased cancer recurrence,” said Dr. Shields, who is Deputy Director of The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

“Although the medical community recognizes the importance of smoking cessation, supporting patients in ceasing to smoke is generally not done well. Our hope is that by addressing smoking cessation in a cancer patient population, we can make it easier for oncologists to effectively support their patients in achieving their smoking cessation goals,” said Dr. Shields.

According to the NCCN Guidelines for Smoking Cessation, combining pharmacologic therapy and counseling is the most effective treatment approach to smoking cessation. Furthermore, smoking status should be documented in patient health records and updated at regular intervals. Smoking relapse is common, and providers should discuss relapse and provide guidance for patients.

‘Crucial Addition’ to Guidelines

“The NCCN Guidelines for Smoking Cessation is a crucial addition to the NCCN Guidelines for Supportive Care,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “Addressing the physical and behavioral impact of cigarette smoking dependency and offering a support system for people with cancer can positively impact their quality of life, both during treatment and during survivorship.”

The NCCN Guidelines for Smoking Cessation join a library of 10 additional NCCN Guidelines for Supportive Care, which comprise evidence-based treatment recommendations for supportive care areas. NCCN publishes a full library of 61 clinical guidelines detailing sequential management decisions and interventions that currently apply to 97% of cancers affecting people in the United States, as well as cancer prevention, detection and risk reduction, and age-related recommendations.

Watch for continued coverage of the NCCN 20th Annual Conference in upcoming issues of The ASCO Post. For more information about the NCCN and the NCCN Guidelines, visit, and direct patients and caregivers to ■