BMJ Support Palliat Care 2:312-318 doi:10.1136/bmjspcare-2011-000186
  • Review

The effect of smoking on health-related quality of life in lung cancer patients: a systematic review

  1. Sarah Danson2
  1. 1Department of Psychology, University of Sheffield, Sheffield, UK
  2. 2Academic Unit of Clinical Oncology, Weston Park Hospital, Sheffield, UK
  1. Correspondence to Christine Rowland, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK; C.Rowland{at}


Introduction Given poor survival rates for lung cancer, health-related quality of life (HRQoL) is very important. Smoking is prevalent among those diagnosed with lung cancer, and continued smoking is associated with compromised HRQoL in other patient groups.

Aims A systematic review was conducted to determine: (i) differences in HRQoL between lung cancer patients who smoke compared with those who quit or never smoked and (ii) changes in HRQoL in patients who continue to smoke after diagnosis compared with those who quit or never smoked.

Method Scopus, Medline, PubMed, PsychINFO and Web of Knowledge from January 1995 to June 2010 were searched. The included studies were assessed and given a score for quality.

Results Eight studies met the inclusion criteria. Four studies showed that lung cancer patients who smoked report impaired HRQoL compared with those who never smoked or had quit. Smokers reported significantly lower HRQoL than former smokers, who in turn reported lower HRQoL than never smokers. This finding remained consistent over time.

Conclusions When taking account of methodological quality, smoking is associated with poorer HRQoL in lung cancer patients. These results suggest that programmes are needed to address the specific support needs of this group and promote HRQoL during their final months. Longitudinal research is necessary to further understand the association between smoking and HRQoL.

  • Received 21 December 2011.
  • Accepted 14 August 2012.
  • Published Online First 11 October 2012

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