Smoking and Breast Cancer

Key takeaways

• Studies suggest a link between smoking and breast cancer. Smoking may increase your risk of breast cancer and can make breast cancer treatment less effective.
• Quit smoking after a cancer diagnosis to improve health outcomes. Stopping smoking benefits people with all types of cancer equally and can lead to better treatment responses.
• A recent study co-led by Mass General Brigham shows treatment programs can help. Researchers found that a telehealth smoking cessation program nearly doubled the quit rates for patients with cancer—1 in 4 of whom had breast cancer.
• Talk to your care team about support and resources. They can advise on medication and counseling programs, like the Smokefree Support Service at Mass General Brigham Cancer Institute, to help you quit smoking before, during, and after cancer treatment.
• Learn about our Lifestyle Medicine Program and how lifestyle changes enhance cancer care and survivorship. Improve your diet, stay active, and manage stress to help boost your overall health and treatment outcomes.

Most people know that smoking tobacco causes lung cancer. But did you know that smoking is linked to other cancers, including breast cancer?

The latest U.S. Surgeon General’s report on smoking confirmed it may increase your risk of developing breast cancer and make breast cancer treatment less effective.

Eliminating risky substances like tobacco is just one lifestyle change to benefit your health in breast cancer care and survivorship. Evidence-based support like the Lifestyle Medicine Program at Mass General Brigham Cancer Institute can help you quit smoking and build other healthy lifestyle habits before, during, and after cancer treatment.

“Quitting smoking is one of the best things you can do for your health, especially following a cancer diagnosis, but this is challenging for many people,” says Elyse R. Park, PhD, MPH, a Mass General Brigham psychologist. “We recently demonstrated that a virtual treatment program with smoking cessation counseling helped nearly double quit rates in people diagnosed with cancer—1 in 4 of whom had breast cancer.”

Dr. Park is program director of the Mass General Brigham Cancer Institute’s Smokefree Support Service, which provides free tobacco treatment support to any patient in the system who has been diagnosed with and treated for cancer. She recently co-led a national study published in the Journal of Clinical Oncology that showed the benefit of a virtual program to help patients with cancer quit smoking.

In this article, Dr. Park shares insights from the study that underscore the power of lifestyle medicine.

Can smoking cause breast cancer?

Smoking may increase your risk of breast cancer. Research shows your risk may increase when you smoke for a longer period of time, smoke more frequently, or start smoking at a younger age.

One out of every 3 cancer deaths is related to cigarette smoking, according to the Centers for Disease Control and Prevention (CDC). Smoking causes 12 types of cancers, including lung, colorectal, and cervical cancer.

Quitting smoking is one of the most important things you can do to reduce your risk of cancer and improve your health.

Smoking and cancer care

Most people who smoke continue to do so after a cancer diagnosis. Quitting may be even more challenging with the stress of your diagnosis and side effects from treatment. But smoking may have a negative effect on cancer treatment and survivorship for any type of cancer.

In both patients with cancer and cancer survivors, the CDC states that smoking:

• Increases risk of death
• Increases risk of developing other cancers related to smoking
• May increase risk of cancer recurrence
• May lead to poorer treatment response and more harmful side effects related to treatment

Stopping smoking after a cancer diagnosis helps prevent these negative impacts on your health and cancer treatment—for you and your family. Your health benefits from quitting smoking no matter what type of cancer you have, even if the cancer isn’t related to smoking. Resources are available and treatment programs can help you quit.

Ways to stop smoking during and after cancer treatment

The National Comprehensive Cancer Network (NCCN) shares guidelines to help people with cancer stop smoking. They recommend the most effective method is a combination of both:

• Medications such as nicotine replacement therapy, like nicotine patches or gum, and a prescription medication called varenicline
• Behavioral counseling from a health care professional who can help you recognize your triggers, handle situations where you’re more likely to smoke, and address other barriers to quitting

Your care team helps you navigate all that comes with cancer treatment. They help you manage side effects, improve your health, and make treatment as effective as possible. Dr. Park emphasizes that support for quitting smoking should be part of that.

“Tobacco treatment is an essential part of cancer care,” she says. But many patients who receive cancer treatment at a community site, rather than an academic hospital, don’t have access to an effective program to quit smoking.

Smoking cessation programs

Many people try to quit after their cancer diagnosis, and tobacco treatment support helps them quit smoking and “stay quit.” Research shows that these smoking cessation programs help patients live longer when they start within 6 months after their diagnosis.

Dr. Park co-led a clinical trial that showed the benefit of a virtual smoking cessation program for patients with cancer—and about 1 in 4 of these patients had breast cancer. The treatment program offered therapy via telehealth sessions and nicotine replacement medications.

The participants had recently received a cancer diagnosis. In addition to cancer treatment with their oncologist, they had either:

• A referral to the National Cancer Institute’s Quitline, a free counseling service over the phone, or
• Up to 11 telehealth sessions with counselors who help people quit smoking, and free nicotine lozenges and skin patches

The researchers found that patients who participated in the telehealth sessions were nearly twice as likely to quit smoking 6 months after the treatment, compared to the other patients. The more sessions a patient took, the more likely they were to quit.

Dr. Park notes that telehealth counseling over video or phone call may be easier for patients to access, especially if they have other in-person appointments or live with side effects from cancer treatment.

In a previous study published in JAMA, Dr. Park and researchers also showed the benefit of longer-term smoking cessation counseling and medication in patients recently diagnosed with cancer—1 in 4 of whom had breast cancer. The study helped lead to the Smokefree Support Service now at Mass General Brigham, which offers free one-on-one or group smoking cessation support to patients treated at the Cancer Institute. Patients can call 617-724-2445 to learn more about the program.

Dr. Park’s research shows how people with cancer can benefit from these support programs, including patients with breast cancer as they were such a large part of both studies.

How to help someone quit smoking

Friends, family, and caregivers can also help someone quit smoking before, during, or after cancer treatment. You can let them know you’re around to talk when they need, and you can ask how you can best support them. It may help if you regularly check in on them, do activities to keep their mind off it, or offer to help with chores or tasks to lighten the stress.

You can also help them get what they need to stop smoking. Candy, straws, or gum can help with the oral fixation of smoking, and you can offer to pick up over-the-counter nicotine replacement medication like gum or patches.

Lifestyle medicine to improve cancer care and outcomes

Quitting smoking is just one lifestyle change that benefits your cancer treatment outcomes and helps reduce risk of new cancer. Alcohol is also linked to breast cancer, so quitting or limiting how much you drink helps reduce risk.

Lifestyle medicine is a holistic approach to cancer care that focuses on different aspects of your health, so you have the best outcomes with your treatment and beyond. Other areas to help your cancer journey include:

• Nutrition
• Physical activity
• Sleep
• Stress management (this is also important for caregivers)
• Rehabilitation

Talk to your oncologist or primary care provider (PCP) if you’d like support to quit smoking, or with other areas of health. Your care team is there to help you manage cancer treatment and navigate life after cancer, too.