How to reduce the risk of lung cancer
In
the United States, lung cancer remains the leading cause of cancer death in
both men and women. Death from lung cancer alone is greater than the
combined total of breast, prostate, colon, liver, and kidney cancer deaths. The
5-year survival rate for patients diagnosed with lung cancer is only 15%. Data
show that in the United States, 150,000 are diagnosed with lung cancer and
another 200,000 die from this disease each year. Despite the high death rates associated
with lung cancer, there are several things that can be done to reduce the
chances of lung cancer. The most
common risk factors for lung cancer and steps to reduce these risks will be
reviewed here.
What
are the risk factors for lung cancer?
A
risk factor can be anything that affects the chances of getting a disease. Smoking is the risk factor most commonly
associated with lung cancer, causing between 80% and 90% of lung cancers. Secondhand smoke, which is also
associated with lung cancer, accounts for about 50,000 lung cancer deaths in
nonsmoking adults each year in the United States. Risk factors for lung cancer include:
·
Cigarette smoking
·
Exposure to secondhand
smoke (tobacco smoke exhaled by a smoker)
·
Radon gas in the home
or environment
·
Things around home or
work including asbestos, ionizing radiation, and other cancer-causing
substances
·
Medical exposure of radiation
to the chest area
·
Chronic lung disease
such as emphysema or chronic bronchitis
·
Increased age
Since
smoking is the biggest risk factor for lung cancer, quitting smoking is the
best way to reduce chances of lung cancer. There are also many other benefits
of quitting smoking.
What are the benefits of quitting?
Some
of the immediate benefits are a reduction in heart rate and blood pressure.
Those who quit smoking will also experience less coughing and wheezing.
Most importantly, people who quit smoking significantly reduce their risk of
cancer and other smoking-related diseases such as chronic obstructive pulmonary
disease. Data have shown that smokers who quit for 10 years decrease their risk
of lung cancer by 30% to 50%. Furthermore, smokers who quit can protect the
nonsmokers around them by decreasing their risk of lung cancer that is
associated with secondhand smoke. Quitting smoking at any age is beneficial;
however, quitting early is associated with the most benefit.
Does a less harmful tobacco product
exist?
All
forms of tobacco including hookahs (waterpipes), cigars, smokeless tobacco
(chewing tobacco and snuff), pipes, bidis (flavored cigarettes), and kreteks (cigarettes
containing a mixture of tobacco and cloves) are harmful. Light cigarettes and electronic
cigarettes show no benefit in quitting smoking and can be just as harmful as
regular cigarettes. Electronic cigarettes, also known as e-cigarettes, are new
to the marketplace and are promoted as safer alternatives to smoking by its
manufacturers. However,
when the Food and Drug Administration (FDA) analyzed the vapor produced by
electronic cigarettes, cancer-causing agents were found. Thus, no cigarette, whether electronic
or conventional, is safe.
What are some ways to quit smoking?
When
trying to quit smoking, talk with a healthcare professional such as your doctor
or pharmacist. They can provide you with information on the benefits of
quitting and even help you start drug therapy if needed. It has been shown that
smokers who talk with their doctor or pharmacist about quitting have a greater
chance of not smoking again.
Nicotine
replacement therapy (NRT) can be a vital tool to help quit smoking and has been
shown to increase the rate of quitting by 50% to 70%. NRTs include the gum,
lozenge, patch, nasal spray, and inhaler. These drugs are designed to slowly
wean your body off of its addiction to nicotine. The gum, lozenge, and patch are available as over-the-counter
products, whereas the nasal spray and inhaler are only available by
prescription. In addition to the NRTs, there are also 2 non-nicotine medications
that are currently available to help quit smoking. These are bupropion (also
known as Zyban) and varenicline (also known as Chantix). These agents require
you to see your doctor for a prescription. Before starting any of these
therapies, talk to your doctor or pharmacist to make sure that these products
are right for you. The chart below provides a brief overview of the products.
FDA-Approved Medications for Quitting
Smoking
Medications
|
Precautions
|
Pros
|
Cons
|
Nicotine gum
• OTC
• Generic, Nicorette
|
·
Caution in patients with dentures or serious
heart problems
·
Do not eat or drink 15 minutes before or
during use
|
·
May help satisfy oral cravings
·
May delay weight gain
·
Variety of flavors available
|
·
May need to use frequently to manage
withdrawal symptoms
·
Must use proper chewing technique
·
Side effects may include mouth soreness and upset
stomach
|
Nicotine lozenge
• OTC
• Generic, Commit
|
·
Caution in patients with serious heart
problems
·
Do not eat or drink 15 minutes before or
during use
|
·
May help satisfy oral cravings
·
May delay weight gain
·
Easy to use and conceal
·
Variety of flavors available
|
·
May need to use frequently to manage
withdrawal symptoms
·
Side effects may include hiccups, cough, and
heartburn
|
Nicotine patch
• OTC
• Generic, Nicoderm
CQ
|
·
Caution in patients with serious heart
problems
·
Do not use if you have severe eczema,
psoriasis, or other skin problems
|
·
Provides consistent nicotine levels
·
Easy to use and conceal
·
Applied once daily
|
·
Side effects may include skin reactions,
headache, and sleep disturbances (insomnia, abnormal/vivid dreams)
|
Nicotine inhaler
• Prescription only
• Nicotrol inhaler
|
·
Caution in patients with serious heart problems
or asthma
·
Do not store cartridges in very warm or very
cold conditions
|
·
Similar hand-to-mouth ritual of smoking
·
May be helpful for menthol cigarette smokers
|
·
May need to use frequently to manage
withdrawal symptoms
·
Side effects may include mouth/throat
irritation (improves with use), couch, hiccups, upset stomach, and runny nose
|
Nicotine nasal spray
• Prescription only
• Nicotrol NS
|
·
Caution in patients with serious heart
problems, chronic nasal disorders, and severe reactive airway disease
|
·
Acts rapidly to manage withdrawal symptoms
|
·
May need to use frequently to manage
withdrawal symptoms
·
Side effects may include nasal/throat
irritation, runny nose, tearing, sneezing, cough and headache
|
Bupropion SR
• Prescription
• Generic, Zyban
|
·
Caution in patients with severe liver disease, depression, or
other mental illness
Not for use if you:
·
Currently or recently used monoamine oxidase (MAO) inhibitors
·
Use bupropion in any other form, have a
history of seizures or eating disorders
|
·
Does not contain nicotine
·
Easy to use and can be used with NRT
·
May be beneficial in patients with depression
|
·
Side effects may include insomnia, dry mouth,
rash, constipation, nervousness
·
Seizure risk is increased
·
Several contraindications and precautions
|
Varenicline
• Prescription only
• Chantix
|
·
Caution in patients with heart problems, severe
kidney disease, serious mental illness, and in patients receiving dialysis
|
·
Does not contain nicotine
·
Easy to use
·
May be helpful for those who failed other
agents
|
·
Side effects may include nausea, insomnia, and
abnormal, vivid, or strange dreams, and constipation
·
May cause depressed mood, agitation, changes
in behavior, and suicidal thoughts
·
Small risk of new or worsening heart or blood
vessel problems (mostly in patients who already have a heart condition)
|
What are some additional tips to quit smoking?
One
of the best ways to avoid smoking is to be proactive. The first step includes
setting a goal quit date. Tell your friends and family that you are quitting.
Additionally, make a list of your smoking triggers and develop a plan for
dealing with them. For example, when you first wake up, avoid smoking by
performing moderate exercise or walking. Everyone is going to have a different
method to help them quit. The key is to seek help and support when needed. Also,
do not be discouraged if you are not successful at quitting after the first
try. It takes the average smoker about 7 to 10 attempts at quitting before
being successful.
Where can I get help to quit smoking?
There
are many resources to assist in quitting. Below are a few helpful resources.
·
Smokefree.gov
website provides tools, information, and support to smokers who are looking to
quit.
·
National Cancer
Institute’s Smoking Quitline (1-877-44U-QUIT or 1-877-448-7848) offers free
counseling and answers to smoking-related questions in English or Spanish. They
are available Monday through Friday from 8am to 8pm Eastern Time.
·
LiveHelp Online Chat is
another service provided by the National Cancer Institute that allows you to communicate
with smoking cessation counselors via online text chat. They are available
Monday through Friday 8am to 11pm Eastern Time. This service can be accessed at
https://livehelp.cancer.gov/app/chat/chat_launch.
·
Your state also has a
toll-free telephone quit line (1-800-QUIT-NOW) that can provide you with
assistance and additional resources.
Written
By:
Laurel
Park
Doctor
of Pharmacy Candidate 2013
UIC
College of Pharmacy/UIC Pharmacy
Naeil
Elhaj
Doctor
of Pharmacy Candidate 2013
UIC
College of Pharmacy/UIC Pharmacy
