"Since a substantial number of patients presenting with lung cancer either smoked in the recent past or continue to do so, it is important to make sure that the patient stops smoking as soon as possible to improve their treatment outcome," says Dr. Carolyn M. Dresler, Head, Tobacco and Cancer Group of the International Agency for Research on Cancer. She added, "the emphasis should be on improvement of treatment outcome and future health improvement."

There are guidelines regarding smoking cessation techniques that have resulted from reviews of the world's literature and are very well accepted throughout the medical and psychological fields. However, "the biggest problem remains in having healthcare providers implement them routinely," Dr. Dresler says, "Most have emphasized the role of the primary healthcare provider in providing smoking cessaton advice to patients, whereas the specialists, such as medical oncologists, radiation oncologists, thoracic surgeons or pulmonary care specialists should be dealing with the health problems resulting from the smoking as the patient faces imminent interventions such as radiation therapy, chemotherapy or surgery."

She makes the point that since ongoing smoking may significantly affect the outcome of subsequent surgery or therapy and negatively impact long-term survival, it is now the specialists' turn to provide the urgent smoking cessation treatment. With the advent of medicare changes under the new Medicare Modernization Act (MMA), the specialists will be reimbursed for providing evaluation and management services, making referrels for diagnostic testing, radiation therapy, surgery and other procedures as necessary, and offer any other support needed to reduce patient morbidity and extend patient survival. I certainly hope they add smoking cessation guidance and support.

www.treatobacco.net is an evidence-based site containing information in 11 languages on tobacco dependence treatment relative to efficacy, safety, demographics and health effects, health economics, and policy.

www.cdc.gov/tobacco/ is a site to let you know everything you wanted to know about tobacco at the CDC.

www.guideline.gov/summary/summary.aspx?doc_id=2958&nbr=2184 is the National Guideline Clearinghouse web site for smoking cessaton.