Primary prevention
Smoking cessation
Patients should be asked about current smoking status (including e-cigarettes and vaping products) on each presentation to medical care. Integration of smoking cessation efforts into care should be implemented.[25] Smokers should be educated about the health risks of smoking and advised to quit. There are multiple options (nonpharmacologic and pharmacologic) that are available to assist patients with smoking cessation.
The US Preventive Services Task Force (USPSTF) recommends smokers be directed to Food and Drug Administration-approved pharmacotherapy for smoking cessation. The USPSTF found insufficient evidence on the use of e-cigarettes for tobacco smoking cessation in adults and concluded that the balance of benefits and harms cannot be determined.[26]
Vitamin supplements
One systematic review and meta-analysis of randomized controlled trials found no beneficial effect of vitamin supplements for the prevention of lung cancer and lung cancer mortality.[27]
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The USPSTF recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. The USPSTF concluded that current evidence is insufficient to assess the balance of benefits and harms regarding the use of multivitamin supplements for the prevention of cardiovascular disease or cancer.[28]
Secondary prevention
Smoking cessation should be encouraged, even in patients with cancer.[5][25]
Continued smoking among patients with SCLC has been associated with a significantly increased risk of all-cause mortality, development of a second primary tumor, and disease recurrence.[85] In contrast, quitting smoking at the time of diagnosis or after has been associated with a reduced risk of death.[86]
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