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Behavioral and Psychological Factors in Cancer Risk 

Behavioral and Psychological Factors in Cancer Risk
Psycho-Oncology (3 ed.)

Tobacco use is responsible for at least 30% of all cancer deaths; smoking cessation is associated with decreased mortality and morbidity. This chapter reviews the evidence-based treatments for tobacco use and dependence, drawing primarily from the US Public Health Service’s Clinical Practice Guidelines. The treatments reviewed include pharmacotherapy, behavioral interventions, and combination therapies. FDA-approved pharmacotherapies include nicotine replacement therapies, bupropion, and varenicline. Social/behavioral interventions include brief and intensive counseling, telephone quitlines, and self-help. The chapter also discusses special issues of relevance for treating cancer patients. There is a growing body of evidence that smoking following cancer diagnosis has a negative impact on cancer treatment efficacy, treatment-related complications and side effects, cancer recurrence and second malignancies, and overall survival. The chapter describes the benefits of smoking cessation in cancer patients, reviews cessation and relapse rates among cancer patients, and summarizes the current knowledge regarding cessation interventions targeted to cancer patients.

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