Talking With Your Doctor About Your Tobacco Use

Approved by the Cancer.Net Editorial Board, 04/2016

Many people with cancer may not want to tell their doctor or another member of the health care team about their tobacco use. Why?

  • They worry that the doctor or their family will judge or blame them.

  • They think that they may receive less support for their cancer treatment.

  • They believe that quitting after a cancer diagnosis is pointless; the damage is already done.

  • They feel that they will need to use tobacco to handle the stress of living with cancer.

  • They have tried to quit before but just can’t stop.

You may have these feelings, but it is critical to know that quitting tobacco use at any time can improve your health, even after a cancer diagnosis. Your health care team wants to help you reach this goal.

Taking an honest look at your tobacco use

Many people believe that smoking and using tobacco is a lifestyle choice. It is not. It is an addiction. No matter what your level of tobacco use, your addiction will make it harder to stop, even if you want to quit. Quitting tobacco use is a cycle. Many people will need to try many times before they finally reach their goal of a tobacco-free life.

The Heaviness of Smoking Index (HSI) is a simple way of measuring the strength of a person’s addiction to nicotine.


On the days that you smoke, how soon after you wake up do you have your first cigarette?
  1. Within 5 minutes (3 points)

  2. 6–30 minutes (2 points)

  3. 31–60 minutes (1 point)

  4. After 60 minutes (0 points)

How many cigarettes do you typically smoke per day?
  1. 10 or fewer (0 points)

  2. 11–20 (1 point)

  3. 21–30 (2 points)

  4. 31 or more (3 points)

Results (add up your points)

0–2 points: low addiction

3–4 points: moderate addiction

5–6 points: high addiction

To give yourself the best chance to quit, you need to talk openly and honestly with your doctor about your tobacco use. Your doctor needs to know how much nicotine you use to find the right treatment to help you quit. Let your doctor know if your spouse, family, or close friends use tobacco, too.

Think about your tobacco use and read the questions below. You will want to let your doctor know about your history of tobacco use.

  • Have you ever smoked (at least 100 cigarettes in your life)?

  • Do you smoke every day or some days?

  • How soon after waking up do you smoke your first cigarette?

  • How many years have you been smoking?

  • How many cigarettes do you smoke per day?

  • How old were you when you started smoking?

  • If you’ve quit or cut down, how long has it been since you smoked regularly?

  • How many times have you tried to quit smoking? How long were you able to quit each time?

  • What methods have you used or are using now to try to quit smoking?

  • Do people in your household smoke?

  • Is smoking allowed in your workplace?

  • Have you ever used forms of tobacco other than cigarettes? How often you have used them?

  • Has your tobacco use changed after being diagnosed with cancer?

Myths about smoking and quitting

Myth: Smoking is entirely a personal choice.

Fact: Tobacco contains nicotine. Nicotine is addictive. Nicotine addiction is so powerful that it can be considered a “brain disease” because of the way it affects receptors in the brain and throughout the body. Many people who start smoking quickly become addicted to nicotine.

Myth: There is no point in quitting smoking now that I have cancer.

Fact: It is never too late to quit smoking. People who quit smoking after a cancer diagnosis live longer, have a better chance of successful treatment, have fewer side effects from treatment, recover faster, and have a better quality of life.

Myth: Smoking will help me deal with the stresses of cancer treatment. It will be too stressful to quit smoking at the same time.

Fact: Nicotine does not help with stress relief. The calming effect you feel when you smoke is actually the relief of nicotine withdrawal. The symptoms of nicotine withdrawal can begin just 20 minutes after your last cigarette. Breaking a nicotine addiction is hard and uncomfortable. But the health benefits of quitting outweigh the discomfort.

Myth: Smokers can quit on their own. A doctor’s advice isn’t needed.

Fact: Smoking is an addiction. While some people are able to quit on their own, most people are more successful when they have the help of clinicians, family, and friends. There are many effective tools to improve your chances of quitting. Doctors and other members of a health care team are available to provide support, information, and any necessary medications to help people quit.

Myth: Most tobacco-quitting programs have a low success rate.

Fact: Quitting smoking is hard and often requires several attempts until a person is permanently tobacco-free. Research has proven that counseling and medications improve the odds that you can quit smoking for the long term. There are several medications that can help you deal with nicotine withdrawal. Ask your doctor and other members of your health care team for help.

Myth: If my doctor does not discuss tobacco use, then it must not be important for my cancer treatment.

Fact: The data are conclusive. In 2014, the Surgeon General released the report The Health Consequences of Smoking—50 Years of Progress. The report concludes that cancer patients and survivors who smoke are at increased risk of cancer coming back, getting a second cancer, and death. The dangerous risks of smoking apply to all cancer types and treatments.

Questions to ask your doctor

Your doctor is your partner in your effort to quit. Consider asking your doctor the following questions:

  • Your doctor is your partner in your effort to quit. Consider asking your doctor the following questions:

  • What medications can help me stop?

  • How can I change my lifestyle to make quitting easier?

  • How can I avoid situations that make me want to smoke or use tobacco?

  • How can you and your team help me manage the stress of quitting along with the stress of a cancer diagnosis?

  • What resources for quitting smoking or tobacco use are in my community?

  • How can my family and friends help me?

  • How often should we discuss my progress?

More Information

How to Quit Smoking and Using Tobacco

Your Plan to Quit