It’s never too late to quit smoking, even if smoking has been a big part of your life. Within hours, days, and weeks of quitting, your health will improve. Heart rate and blood pressure, which are elevated in smokers, will begin to return to normal levels. By remaining smoke-free for several years, you can lower your risk of chronic diseases such as heart disease, chronic pulmonary disease (COPD), and cancer.

Oncologists strongly encourage those just diagnosed with cancer to quit using tobacco products as well. That’s because stopping smoking makes cancer treatments more effective, lessens treatment complications, and decreases the chances of cancer returning—or a secondary cancer from forming. These benefits still occur, even if the cancer was not caused by smoking.

Yale Cancer Center, a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, is committed to compassionate, leading-edge care for cancer patients. Our Tobacco Treatment Service is here to help smokers quit. It is designed to give you the support you need to successfully stop smoking. 

“The single most important step smokers diagnosed with cancer can take to improve their health and cancer prognosis is to stop smoking. And we can help patients do just that with our two-pronged approach, which includes counseling and medication,” explains Margaret Antenucci, APRN, a psychiatric nurse practitioner and clinician who provides tobacco treatment through Yale Cancer Center at Smilow Cancer Hospital.

Tobacco products contain many chemical additives, cancer-causing agents (carcinogens), and nicotine, the substance that makes smoking addictive.

Each puff of a cigarette exposes smokers to a toxic cocktail of 7,000 chemicals, including formaldehyde, arsenic, and cadmium—to name a few of the 69 that are known as cancer-causing, according to the NCI. Nonsmokers are also exposed to these chemicals through secondhand smoke.

Smoking can cause cancer in almost any part of the body, including the following:

• Bladder
• Blood (acute myeloid leukemia)
• Bronchus
• Cervix
• Colon and rectum (colorectal)
• Esophagus
• Kidney and ureter
• Larynx
• Liver
• Lung
• Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
• Pancreas
• Stomach
• Trachea

Other negative health effects from smoking include an increased risk for coronary heart disease, cardiovascular disease, stroke, aneurysms, COPD, emphysema, diabetes mellitus, osteoporosis, rheumatoid arthritis, macular degeneration, cataracts, asthma symptoms, erectile dysfunction, tooth loss, and pregnancy complications, including stillbirths and low-birth weight.

Exposure to tobacco smoke increases the risk of illnesses, including lung cancer, stroke, and heart disease in nonsmokers as well, according to the Surgeon General.

It’s also important to note that tobacco comes in many forms, but none are safe. Cigars, pipes, and smokeless (chewing) tobacco also cause cancer and other health problems.

Although the newest smoking trend—vaping—does not contain tobacco, the potential benefits of these devices for tobacco cessation or reducing tobacco harm exposure still remain to be determined. Although more research needs to be done on this and to learn more about the negative health effects of vaping, what is known is that many vaping products contain nicotine, often in high doses, which is addictive.

When you stop smoking, your health will begin to improve in some or all of the following ways:

• Increased blood oxygen levels
• Decreased heart rate, blood pressure, and chance of heart attack
• Better circulation
• Decreased risk for lung cancer and head and neck cancers
• Lower heart disease risk
• Improved lung health, including less coughing and wheezing
• Healthier skin, teeth, and gums
• Increased fertility

In addition, people who stop smoking by age 40 cut their risk of dying prematurely from diseases related to smoking, such as cancer, heart disease, and COPD, by 90 percent. Those who quit smoking between ages 45 to 54 reduce their risk by two-thirds. 

Oncologists encourage their patients to stop smoking before or during treatment because of research showing the following health benefits:

• Improved response to chemotherapy and radiation therapy
• Decreased risk of surgical complications
• Shorter recovery time from surgery
• Fewer reported cancer treatment side effects
• Lower risk of developing pneumonia and respiratory difficulties
• Reduced risk of cancer returning or developing new or secondary cancers.

Smoking can be a difficult habit to break because the body becomes addicted to the nicotine, the main ingredient in cigarettes. When you stop smoking, nicotine withdrawal can cause symptoms such as cravings, irritability, mood changes, sleep problems, restlessness, and difficulty concentrating. But these are only temporary. For most people, withdrawal symptoms only last from a few days to a few weeks. 

Here at Yale Cancer Center, our tobacco treatment providers use medication-assisted treatment with FDA-approved prescription drugs for tobacco cessation, along with counseling to help reduce nicotine withdrawal symptoms and help you resist cravings.

To help counteract cravings and other withdrawal symptoms, our providers may use the following medications as smoking cessation aids:

• Nicotine replacement patches, gum, lozenges, inhalers, or nasal sprays
• Varenicline (Chantix), an oral medication that works by preventing nicotine from binding to receptors in the brain, decreasing cravings for cigarettes
• Bupropion SR (Zyban or Wellbutrin), an oral medication typically used as an antidepressant that also decreases craving for nicotine

Medications are most effective when accompanied by counseling and education to encourage behavioral changes. Doctors and nurse practitioners who specialize in tobacco treatment focus on helping you work on your tobacco use—on your timeline—and gain specific skills to prevent or handle “slips” when they happen and maintain your long-term goals. 

Our Tobacco Treatment Service includes a multidisciplinary team of physicians, advanced nurse practitioners, psychologists, and clinical research staff all focused on helping people quit smoking. We tailor treatment to meet the unique needs of each patient. We are flexible and able to adapt support to each patient’s needs in a number of ways. Patients can be seen in-person or via telemedicine video calls at Smilow Cancer Hospital or a Smilow Care Center closer to their home. Our program can also connect patients to external tobacco treatment resources like the NCI texting program (SmokeFreeTXT) and the CT quitline (1-800-QUIT-NOW).  

“We appreciate the challenges of cancer diagnosis, treatment, and survivorship,” says Yale Medicine’s Lisa Fucito, PhD, director of the Tobacco Treatment Service at Smilow and associate professor of psychiatry at Yale School of Medicine. “Our goal is to make tobacco treatment services as convenient as possible so that patients can receive the help that they need. It is important to integrate tobacco and cancer treatment as soon as possible so that patients can reduce the risks of continued smoking on their cancer prognosis.”

The standard of care for tobacco treatment has changed, explains Dr. Fucito. “We used to only offer treatment to individuals if they were motivated to stop. But, we know that tobacco cessation medications can promote smoking changes even among individuals who may not be ready to quit just yet. Therefore, Yale Cancer Center is committed to providing tobacco treatment to all patients with cancer who smoke.”