National Cancer Institute


Posted Date: Aug 31, 2013

Expert-reviewed information summary about research and guidelines focused on the prevention and cessation of cigarette smoking.

Cigarette Smoking: Health Risks and How to Quit

What is prevention?

Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.

To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer.

Different ways to prevent cancer are being studied, including:

General Information About Tobacco Use

Key Points for this Section

  • Smoking is the leading cause of cancer in the United States.
  • Smoking causes many other health problems.
  • Being exposed to secondhand smoke increases the risk of cancer and other diseases.

Smoking is the leading cause of cancer in the United States.

Smoking increases the risk of many types of cancer. These include:

A smoker’s risk of cancer can be 2 to 10 times higher than it is for a person who never smoked. This depends on how much and how long the person smoked.

In 2011, about 22% of adult men and about 16% of adult women were smokers. Lung cancer is the leading cause of cancer death in both men and women. In the last 30 years, the total number of smokers has decreased, especially among men. Since the 1980s, deaths caused by lung cancer in men have been decreasing.

Smoking causes many other health problems.

Smoking is linked with many diseases besides cancer. These include:

Other health problems that may be linked to smoking are:

Smoking during pregnancy may cause problems such as slow growth of the fetus and low birth weight.

Being exposed to secondhand smoke increases the risk of cancer and other diseases.

Smoking can also affect the health of nonsmokers. Smoke that comes from the burning of a tobacco product or smoke that is exhaled by smokers is called secondhand smoke. Inhaling secondhand smoke is called involuntary or passive smoking.

The same cancer-causing chemicals inhaled by tobacco smokers are inhaled in lower amounts by people exposed to secondhand tobacco smoke. Nonsmokers who are exposed to secondhand smoke have a higher risk of lung cancer and coronary heart disease. Children exposed to tobacco smoke have higher risks of the following:

Health Risks of Smoking and Ways to Quit

Key Points for this Section

  • Quitting smoking improves health in smokers of all ages.
  • Different ways to quit smoking have been studied. The following are the most common methods used to help smokers quit:
    • Counseling
    • Drug treatment
    • Smoking reduction
  • Cancer prevention clinical trials are used to study ways to prevent cancer.
  • New ways to help smokers quit are being studied in clinical trials.

Quitting smoking improves health in smokers of all ages.

The risk of most health problems from smoking, including cancer and heart and lung disease, can be lowered by stopping smoking. People of all ages can improve their health if they quit smoking. Quitting at a younger age will improve a person's health even more. People who quit smoking cut their risk of lung cancer by 30% to 50% after 10 years compared to people who keep smoking, and they cut their risk of cancer of the mouth or esophagus in half within 5 years after quitting.

The damage caused by smoking is even worse for people who have had cancer. They have an increased risk of cancer recurrence, new cancers, and long-term side effects from cancer treatment. Quitting smoking and stopping other unhealthy behaviors can improve long-term health and quality of life. See the PDQ summary Smoking in Cancer Care for more information.

The Public Health Service has a set of guidelines called Treating Tobacco Use and Dependence. It asks health care professionals to talk to their patients about the health problems caused by smoking and the importance of quitting smoking.

Different ways to quit smoking have been studied. The following are the most common methods used to help smokers quit:

Counseling

People who have even a short counseling session with a health care professional are more likely to quit smoking. Your doctor or other health care professional may take the following steps to help you quit:

  • Ask about your smoking habits at every visit.
  • Advise you to stop smoking.
  • Ask you how willing you are to quit.
  • Help you plan to quit smoking by:setting a date to quit smoking;giving you self-help materials;recommending drug treatment.
    • setting a date to quit smoking;
    • giving you self-help materials;
    • recommending drug treatment.
  • Plan follow-up visits with you.

Childhood cancer survivors who smoke may be more likely to quit when they take part in programs that use peer-counseling . In these programs, childhood cancer survivors are trained in ways to give support to other childhood cancer survivors who smoke and want to quit. More people quit smoking with peer-counseling than with self-help programs. If you are a childhood cancer survivor and you smoke, talk to your doctor about peer-counseling programs.

Drug treatment

Treatment with drugs is also used to help people quit smoking. These include nicotine replacement products and non-nicotine medicines. People who use any type of drug treatment are more likely to quit smoking after 6 months than those who use a placebo or no drug treatment at all.

Nicotine replacement products have nicotine in them. You slowly reduce the use of the nicotine product in order to reduce the amount of nicotine you take in. Using a nicotine replacement product can help break the addiction to nicotine. It lessens the side effects of nicotine withdrawal, such as feeling depressed or nervous, having trouble thinking clearly, or having trouble sleeping. Nicotine replacement products that have been shown to help people quit smoking include:

Nicotine replacement products can cause problems in some people, especially:

  • Women who are pregnant or breast feeding.
  • Teenagers.
  • People with any of the following medical problems:Heart rhythm problems. High blood pressure that is not controlled. Esophagitis. Ulcers. Insulin-dependent diabetes.Asthma.
    • Heart rhythm problems.
    • High blood pressure that is not controlled.
    • Esophagitis.
    • Ulcers.
    • Insulin-dependent diabetes.
    • Asthma.

Other medicines that do not have nicotine in them are used to help people quit smoking. These include:

These medicines lessen nicotine craving and nicotine withdrawal symptoms.

It is important to know that bupropion and varenicline may cause serious psychiatric problems. Symptoms include:

Before starting to take bupropion or varenicline, talk to your doctor about the important health benefits of quitting smoking and the small but serious risk of problems with the use of these drugs.

Varenicline may also cause serious heart problems.

Smoking reduction

When smokers do not quit smoking completely but smoke fewer cigarettes (smoking reduction). they may still benefit. The more you smoke, the higher your risk of lung cancer and other cancers related to smoking. Studies show that smokers who cut back are more likely to stop smoking in the future.

Smoking less is not as helpful as quitting smoking altogether, and is harmful if you inhale more deeply or smoke more of each cigarette to try to control nicotine cravings. In smokers who do not plan to quit smoking completely, nicotine replacement products have been shown to help them cut down the number of cigarettes they smoke, but this effect does not appear to last over time .

The following resources can help you quit smoking:

  • Consumer information about quitting smoking is available at the www.smokefree.gov Web site.
  • The online Quit Guide may help you understand reasons for smoking and the best ways to quit.
  • The booklet Clearing the Air: Quit Smoking Today can be ordered at 1-800-4-CANCER (1-800-422-6237) or printed here.

Cancer prevention clinical trials are used to study ways to prevent cancer.

Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.

The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

New ways to help smokers quit are being studied in clinical trials.

Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check for clinical trials in NCI's PDQ Cancer Clinical Trials Registry that are accepting patients for trials to quit smoking.

Changes to This Summary (03/15/2013)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Changes were made to this summary to match those made to the health professional version.

Questions or Comments About This Summary

If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s Contact Form. We can respond only to email messages written in English.

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About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

Images in the PDQ summaries are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in the PDQ summaries, along with many other cancer-related images, are available in Visuals Online, a collection of over 2,000 scientific images.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether a certain drug or nutrient can prevent cancer. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients and those who are at risk for cancer. During prevention clinical trials, information is collected about the effects of a new prevention method and how well it works. If a clinical trial shows that a new method is better than one currently being used, the new method may become "standard." People who are at high risk for a certain type of cancer may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

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