Question 1: Is it too late to consider quitting smoking after cancer has been detected? A large body of clinical evidence shows that regardless of whether the cancer is smoking-related or not, treatment outcomes for those who continue to smoke after a cancer diagnosis are significantly worse than those who quit, and this finding is appropriate for patients with many different types of cancer. That is, there is evidence to support the health benefits of quitting smoking, regardless of whether the cancer was caused by smoking. In cancer patients, the comparison of the benefits of quitting smoking and the risks of smoking is reflected in several ways, including: 1) the effect on the efficacy and toxicities of oncologic therapy; 2) the risk of cancer; 3) the risk of cardiovascular and respiratory disease; and 4) the effect on survival Table Question 2: Does smoking have an effect on my cancer treatment? The answer is yes. (1) The vasoconstrictive effect of nicotine affects blood flow and smoking increases circulating concentrations of carbon monoxide, all of which will decrease postoperative wound healing and increase the chance of surgical site infection; (2) Smoking also increases the risk of serious pulmonary comorbidities, including intraoperative and postoperative bronchospasm; and (3) increases general anesthesia comorbidities because smokers have more mucus in their lungs. Because of the numerous risks, many surgeons insist that patients stop smoking for at least 2 weeks prior to surgery, and possibly longer if allowed. Smoking decreases the efficacy of radiation therapy for tumors. Continued smoking increases the toxicity and side effects of radiation therapy, in addition to decreasing the complete response rate. For example, stomatitis, loss of taste, dry mouth, weight loss, fatigue, pneumonia, soft tissue and bone necrosis, and decreased quality of life may be associated with continued smoking. 3. Smoking reduces the efficacy of chemotherapy for oncology Smoking changes the metabolism and mechanism of action of chemotherapy drugs and reduces the effect of chemotherapy; 4. Smoking reduces the quality of survival (1) Smoking weakens immune function, increases the incidence of infection, and aggravates common side effects such as weight loss, cachexia, fatigue, pulmonary and cardiac toxicity; (2) Because smoking affects metabolism, patients’ appetite increases after quitting. Adequate nutrition is important in the treatment of any cancer, and quitting smoking is helpful in preventing weight loss. Question 3: How to help cancer patients quit smoking? 1. Assess the patient’s motivation to quit Patients’ motivation to quit may vary from visit to visit. Not everyone is ready to quit at a specific time, so the level of motivation to quit should also be assessed at each visit. Recommending smoking cessation to the patient has an impact on the patient’s motivation to quit. It is also important to distinguish between the nicotine addicted population, who at the time of diagnosis and treatment are strongly in favor of not smoking, but will become addicted to nicotine and smoke again. Therefore, it is also necessary to fully understand the patient’s past smoking history to clarify the degree of nicotine dependence. For example, people with a history of frequent smoking of more than one box per day or smoking upon waking up are more likely to be addicted to nicotine. Nicotine addiction is different from motivation to quit smoking, which is easily changed. Patients who are more nicotine dependent may need more support to help quit smoking and a more refined cessation treatment plan. 2. Tell patients directly about the dangers of smoking Let patients understand that smoking reduces the effectiveness of surgery and radiotherapy and increases the risk of toxicities and complications. Increase the patient’s motivation to quit smoking in the hope of increasing treatment outcomes and prolonging survival 3. Talk more with the patient about quitting Patients should talk with them at each visit about their attempts to quit, successful quitting, and relapse. Assess the patient’s possible misconceptions about the risks of smoking and quitting, and emphasize in the communication the importance of changing the smoking habit and the benefits that can be derived from quitting. 4. medication for tobacco dependence Treating tobacco dependence can be seen as part of symptom treatment. Inpatient treatment is the best time to reduce the withdrawal symptoms and discomfort that patients experience when quitting. Patients are in a smoke-free environment and can also receive pharmacologic interventions.