La prévention du tabagisme est la prévention la plus efficace du cancer. La poursuite du tabagisme favorise la progression tumorale, augmente le risque de deuxième cancer et diminue la survie des cancers traités. Le diagnostic du tabagisme et la prise en charge de la dépendance tabagique est partie intégrante du traitement des cancers. Les fumeurs atteints de cancer ne fument pas par choix, mais parce qu’ils sont fortement addicts et atteints d’une maladie chronique récidivante. Le traitement comprendra toujours une éducation thérapeutique, une prise en charge psychologique et des médicaments. La combinaison de substituts nicotiniques en patchs et oraux ou la varénicline sont les deux traitements les plus efficaces qui peuvent être prescrits chez des fumeurs cancéreux, sans aucune motivation à l’arrêt. Après arrêt, le patient n’est pas guéri, mais reste un malade atteint de dépendance tabagique en rémission de son tabagisme. Le risque de récidive dans l’année étant de 50 %, le cancérologue en charge du patient utilisera chaque visite pour faire le point du tabagisme et prévenir les rechutes, seul ou avec une aide spécialisée.

Tobacco prevention is the most effective prevention of cancer. Daily smoking promotes tumor progression, increases the risk of second cancer and decreases survival. The diagnosis of smoking and support for cessation and preventing recurrence is an integral part of cancer treatment. Smoking increases side effects of chemotherapy and surgery and reduces the effectiveness of radiotherapy and chemotherapy. Smokers with cancer do not smoke by life-style choice but because they are highly addicted and are suffering from a chronic relapsing disease: tobacco dependence, which justifies intensive medical management. The oncologist himself may perform this support or coordinate with other physicians in charge of the patient or with a tobacco cessation clinic, but patients are often unable to stop alone, as evidenced by the continued to use tobacco despite a cancer diagnosis. Treatment will always include a therapeutic education, compartmental behavioral therapy and medication. The patches and oral nicotine replacement or varenicline are the two most effective treatments that can be prescribed to smokers suffering of cancer, without including those with any motivation to quit. Smoking reducing occurred in a few days or weeks on treatment will allow them to reconsider the judgment. The full stop is always the goal for the doctor, even if it is not the patient initial goal. After stopping, the patient is not cured but still a patient with tobacco dependence who does not smoke. The risk of relapse in the year being 50%. The cancer patient management will use every visit to the point tobacco dependence and prevent relapse, alone or with assistance of a specialist. There is a lack of data on smoking cessation in cancer patients, but no item calls for a three-month quit rate of 50% as observed in the general population after an optimal management of tobacco cessation.