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Despite their increased risk for chronic health conditions and premature death, many cancer survivors continue to smoke after their diagnosis. To enhance the length and health-related quality of their lives, efforts are needed to identify these individuals and provide them with evidence-based interventions to help them quit smoking and remain tobacco free.
As the population of cancer survivors increases and their expected time of survival lengthens, the health behaviors of these individuals is becoming an important focus of attention. Adoption or maintenance of healthy lifestyles after cancer has the potential to reduce both cancer- and non-cancer-related morbidity. Behavioral risk factors, such as smoking, affect survival. Tracking these behaviors permits evaluation of how well cancer control efforts are working to reduce unnecessary disability and death among those with a history of cancer.
Rates of smoking among cancer survivors are based on the self-reporting of individuals with a cancer history who are interviewed as part of the annual population-based National Health Interview Survey (NHIS). Participants were asked whether they were a current smoker.
Healthy People 2020 Target
- There is no Healthy People 2020 target for smoking rates among cancer survivors, though Healthy People does include a national objective to increase the mental and physical health-related quality of life of cancer survivors; however, the goal for the general population is to decrease to 12 percent the proportion of people who smoke.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health Interview Survey, 1992–2017.
|Overview Graph||Detailed Trend Graphs||Most Recent Estimates (2017)|
|Percent of cancer survivors||95% Confidence Interval|
|Ages 18-44||15.9||11.3 - 22.0|
|Ages 45-64||17.5||14.4 - 21.0|
|Ages 65 and older||7.3||5.9 - 9.0|
Compared to Remaining U.S. Population
|Overview graph||Age Group||Cancer Survivor||Remaining U.S. Population|
|Percent of population||Confidence Interval||Percent of population||Confidence Interval|
|Ages 18-44||31.2||28.6 - 34.0||19.4||19.0 - 19.8|
|Ages 45-64||20.4||19.4 - 21.5||19.5||19.1 - 19.9|
|Ages 65 and older||7.9||7.3 - 8.5||9.0||8.6 - 9.3|
Resources are available to assist cancer control planners, program staff, and researchers to design, implement, and evaluate evidence-based survivorship programs. Visit Cancer Control P.L.A.N.E.T.- survivorship for data on cancer incidence, research syntheses, cancer control plans, research-tested interventions, interactive communities of practice, and other resources.
Additional Information on Cancer Survivors and Smoking
- Smokefree.gov. National Cancer Institute.
- SmokefreeTXT. National Cancer Institute.
- Smokefree Women. National Cancer Institute.
- Tobacco. National Cancer Institute.
- Quit Smoking. Springboard Beyond Cancer.
For health professionals
- Tobacco Cessation & Control. American Society of Clinical Oncology.
- Smoking Cessation, Version 1. 2016, NCCN Clinical Practice Guidelines in Oncology. Shields PG, Herbst RS, Arenberg D, et al. J Natl Compre Canc Netw 2016;14(11):1430- 1468.
- Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions (September 2015). U.S. Preventive Services Task Force.
- The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Anthonisen NR, Skeans MA, Wise RA, et al. Ann Intern Med. 2005;142(4):233–9.
- Correlates of continued smoking versus cessation among survivors of smoking-related cancers. Berg CJ, Thomas AN, Mertens AC et al. Psycho-Oncology 2013;22:799–806.
- Mortality from cancer in relation to smoking: 50 years observations on British doctors. Doll R, Peto R, Boreham J, et al. Br J Cancer. 2005;92(3):426-9.
- Tobacco smoking and cancer: a meta-analysis. Gandini S, Botteri E, Iodice S, et al. Int J Cancer. 2008;122(1):155–64.
- Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study. GBD 2015 Tobacco Collaborators. Lancet. 2017;389(10082):1885–1906.
- Tobacco use in the oncology setting: advancing clinical practice and research. Gritz ER, Toll BA, and Warren GW. Cancer Epidemiol Biomarkers Prev. 2014;23(1):3-9.
- 21st-century hazards of smoking and benefits of cessation in the United States. Jha P, Ramasundarahettige C, Landsman V, et al. N Engl J Med. 2013;368(4):341–50.
- Tobacco use and cessation for cancer survivors: an overview for clinicians. Karam-Hage M, Cinciripini PM, and Gritz ER. CA Cancer J Clin. 2014 Jul-Aug;64(4):272-90.
- Cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult cancer. Kaul S, Veeranki SP, Rodriguez AM, Kuo YF. Cancer. 2016 Sep 15;122(18):2895-905.
- Smoking and smoking cessation in relation to mortality in women. Kenfield SA, Stampfer MJ, Rosner BA, and Colditz GA. JAMA. 2008;299(17):2037–47.
- Research priorities, measures, and recommendations for assessment of tobacco use in clinical cancer research. Land SR, Toll BA, Moinpour CM, et al. Clin Cancer Res. 2016;22(8):1907-13.
- Smoking and all-cause mortality in older adults: results from the CHANCES Consortium. Müezzinler A, Mons U, Gellert C, et al. Am J Prev Med. 2015;49(5): e53–e63.
- Lung cancer risk by years since quitting in 30+ pack year smokers.. Pinsky PF, Zhu CS, and Kramer BS. J Med Screen. 2015;22(3):151–7.
- The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Pirie K, Peto R, Reeves GK, et al. Lancet. 2013;381(9861):133–41.
- Use of electronic cigarettes among cancer survivors in the U.S.. Salloum RG, et al. Am J Prev Med. 2016 Nov;51(5):762-766.
- Tobacco smoking and the risk of subsequent primary cancer among cancer survivors: a retrospective cohort study. Siegel RL, Jacobs EJ, Newton CC, et al. JAMA Intern Med. 2015;175(9):1574–6.
- Deaths due to cigarette smoking for 12 smoking-related cancers in the United States. Tabuchi T, Ito Y, Ioka A, Nakayama T, et al. Ann Oncol 2013;24(1):2699–2704.
- 50-year trends in smoking-related mortality in the United States. Thun MJ, Carter BD, Feskanich D, et al. N Eng J Med. 2013;368(4):351–64.
- Smoking-related mortality in the United States. Thun MJ, Lopez AD, Hartge P. N Eng J Med. 2013;368(18):1753.
- Assessing tobacco use by cancer patients and facilitataing cessation: an American Association for Cancer Research policy statement. Toll B, Brandon T, Gritz E, et al. Clin Cancer Res. 2013;19(8):1941-8.
- The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
- The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support. Warren GW, Sobus S, Gritz ER. Lancet Oncol. 2014;15(12): e568–e80.
- Active smoking and mortality among colorectal cancer survivors: the Cancer Prevention Study II nutrition cohort. Yang B, Jacobs EJ, Gapstur SM, et al. J Clin Oncol. 2015;33(8):885–93.