Smoking Cessation Among Cancer Patients in Central and Eastern Europe: Call for Action
Authors: Cedzyńska M. , Marta M. , Koczkodaj P. , Przepiorka I. 
Published: September 2018

Background: Despite the fact that smoking has been linked not only to the development of cancer, but also to prognosis upon diagnosis and risk of death during treatment, many cancer patients continue to smoke. Quitting smoking can be beneficial also after cancer diagnosis, regardless of stage and prognosis. Those benefits are: improved survival outcomes, reduced risk of recurrence and second primary formation, increase treatment response to chemo and radiotherapy, reduced treatment-related complications, better self-reported quality of life related to disease and treatment than among smokers and less pain. The evidence is strong enough to incorporate tobacco dependence treatment into routine cancer care, but in majority of countries in central and eastern Europe (CEE) there are no actions taken to help cancer patients to quit smoking. Aim: To identify main barriers in providing smoking cessation to cancer patients in central and eastern Europe. Methods: Data were collected from participants of Workshop on Tobacco Control and Cessation organized by Cancer Center and Institute of Oncology, Poland and the National Cancer Institute, US. Following countries provided detailed data: Armenia, Georgia, Hungary, Kazakhstan, Kirgizstan, Lithuania, Poland, Macedonia, Serbia. The areas that were investigated: guidelines on smoking cessation dedicated to cancer patients, quit smoking programs for cancer patients, existing literature on barriers for delivery smoking cessation advice and personal opinion of tobacco control experts regarding those barriers. Results: I. Guidelines for smoking cessation among cancer patients have been published only in one country (Serbia) out of nine analyzed countries of the region. II. Programs on smoking cessation dedicated to cancer patients were implemented only in two countries: 1: Poland. Pilot program within National Health Program in 2015 (3 months in cancer centers in two cities). 2: Hungary. In 2012 pilot project. In 2017 National Institute for Pulmonology run 3 workshops on smoking cessation for cancer nurses. III. There is no literature on barriers in incorporating smoking cessation into cancer care in the CEE region. IV. Experts opinions are consistent with worldwide literature findings-the main barriers are lack of knowledge, lack of training, overloading with work focused on diagnosis and cancer treatment, difficulties in implementing systemic changes. Conclusion: There is a strong need to take action in central and eastern Europe to engage oncologists and other cancer healthcare providers into smoking cessation. It is crucial to increase the knowledge on benefits of quitting smoking for cancer patients' health and results of cancer treatment. Sustainable change can be achieved by publishing guidelines and implementing training programs that address the attitudes and beliefs. Implementing systemic changes within cancer centers might be required to improve survival and quality of life of cancer patients in central and eastern European region.