Prevention and Cessation of Cigarette Smoking: Control of Tobacco Use (PDQ®): Prevention - Patient Information [NCI]

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Prevention and Cessation of Cigarette Smoking

Overview of Prevention


Doctors cannot always explain why one person gets cancer and another does not. However, scientists have studied general patterns of cancer in the population to learn what things around us and what things we do in our lives may increase our chance of developing cancer.

Anything that increases a person's chance of developing a disease is called a risk factor; anything that decreases a person's chance of developing a disease is called a protective factor. Some of the risk factors for cancer can be avoided, but many cannot. For example, although you can choose to quit smoking, you cannot choose which genes you have inherited from your parents. Both smoking and inheriting specific genes could be considered risk factors for certain kinds of cancer, but only smoking can be avoided. Prevention means avoiding the risk factors and increasing the protective factors that can be controlled so that the chance of developing cancer decreases.

Although many risk factors can be avoided, it is important to keep in mind that avoiding risk factors does not guarantee that you will not get cancer. Also, most people with a particular risk factor for cancer do not actually get the disease. Some people are more sensitive than others are to factors that can cause cancer. Talk to your doctor about methods of preventing cancer that might be effective for you.

Purposes of this summary

The purposes of this summary on prevention and cessation (stopping) of cigarette smoking are to:

  • Give information on counseling methods used by health professionals to improve quit rates of smokers.
  • Describe various drug treatments used to improve quit rates of smokers.

You can talk to your doctor or health care professional about prevention and cessation methods and whether they would be likely to help you.

Control of Tobacco Use

Tobacco is the leading avoidable cause of cancer and has been estimated to account for about 30% of cancer deaths in the United States. Smoking increases the risk of many types of cancer including acute myeloid leukemia and cancers of the lung, throat, mouth, pancreas, kidney, bladder, cervix, and stomach. Depending on how long and how much a person has smoked, the smoker's risk of cancer can be 2 times to 10 times greater than a nonsmoker's risk.

Smoking is also causally associated with many other diseases besides cancer, including coronary heart disease, stroke, emphysema, and bronchitis, as well as adverse outcomes of pregnancy. Well over 400,000 premature deaths in the United States each year are attributable to cigarette smoking.

Smoking can also affect the health of nonsmokers. The same cancer-causing chemicals found in inhaled tobacco smoke have been found in second-hand tobacco smoke but in lower concentrations. Nonsmokers exposed to second-hand smoke are at increased risk for lung cancer and coronary heart disease, and children exposed to tobacco smoke have elevated risks of sudden infant death syndrome (SIDS), asthma, ear infections and respiratory infections.

In 2007, 22% of adult men and 17% of adult women were current smokers. Cigarette smoking is more common in American Indians/Alaska Natives. Rates of smoking are highest in adults with the least education, and fall as the level of education rises. Lung cancer is now the leading cause of cancer death in both men and women. In the last 30 years, the number of smokers has decreased, especially among men. Since the 1980s, the lung cancer death rate among men has been decreasing.

Prevention and cessation of cigarette smoking

Most of the health problems related to cigarette smoking, including cancer and cardiovascular and respiratory disease, can be reduced by stopping smoking. Quitting smoking is beneficial at all ages, and the earlier in life one quits, the greater the benefits. People who quit smoking cut their risk of lung cancer by 30% to 50% after 10 years compared to continuing smokers, and cut their risk of oral and esophageal cancer in half within 5 years after quitting.

The damaging effects of smoking are even greater for cancer survivors, who have an increased risk of cancer recurrence, new cancers, and long-term side effects from cancer treatment. Stopping behaviors that are harmful to the body, such as smoking, can improve long-term health and quality of life.

Many methods of quitting smoking have been studied. The following are the more common methods used to help smokers quit.

COUNSELING METHODS: People who have even a brief counseling session with a health care professional are more likely to quit smoking. The ASK, ADVISE, ASSESS, ASSIST, and ARRANGE model was developed to help health care professionals with their patients who smoke. Using this model, the physician asks the patient about their smoking status at every visit; advises the patient to stop smoking; assesses the patient's willingness to quit; assists the patient by setting a date to quit smoking, provides self-help materials, and recommends use of nicotine replacement therapy (such as the nicotine patch); and arranges for follow-up visits.

Childhood cancer survivors who smoke may be more likely to quit when they take part in peer-counseling smoking cessation programs. In these programs, trained childhood cancer survivors offer support to other childhood cancer survivors who smoke. More people have been able to quit with peer-counseling than with self-help programs. Childhood cancer survivors who smoke can speak with their doctors about peer-counseling programs.

DRUG TREATMENT: Various drug treatments are successful in helping people quit smoking. These include nicotine replacement products such as nicotine gum, the nicotine patch, nicotine nasal spray, nicotine inhalers, and nicotine lozenges. Non-nicotine medications such as bupropion, an antidepressant, and varenicline, a drug that mimics the way nicotine acts in the body, have also been studied and approved as aids to help people quit smoking. People who use drug treatments, no matter which kind, are more likely to be successful in their effort to quit smoking after 6 months and 12 months than those who use a placebo or no replacement at all.

SMOKING REDUCTION: When smokers fail to completely quit smoking, they may still benefit from reducing the number of cigarettes they smoke. The more a person smokes, the higher his risk of developing lung cancer and other smoking-related cancers. Therefore, using medications or other means to smoke less may reduce smoking-related harms. Studies show that smokers who cut back are more likely to stop smoking in the future. However, smoking less should not be seen as a substitute for quitting smoking altogether, and is harmful if the smoker inhales more deeply or smokes 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 reduce the number of cigarettes they smoked, but this effect does not appear to last over a period of years.

Consumer information about quitting smoking is available at the Web site.

Get More Information From NCI


For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. A trained Cancer Information Specialist is available to answer your questions.


The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.


For more information from the NCI, please write to this address:

NCI Public Inquiries Office
Suite 3036A
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322


The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.

There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.


The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).

Changes to This Summary (10 / 22 / 2009)

The PDQcancer 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

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About PDQ


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.


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.


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.


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).

Date Last Modified: 2009-10-22

If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.

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