Smoking during cancer treatment will add to your bill

Smoking is known to pose significant health risks for cancer patients, but also carries a hefty price tag, according to new research from the Medical University of South Carolina.

Cancer patients who smoked during treatment were more likely than nonsmokers to have their initial treatment fail and ended up spending more on subsequent treatments, according to the study, published Friday in JAMA Network Open.

The findings highlight the significant impact patient behavior has on the total cost of treatment that is already incredibly expensive. Patients can easily spend over $100,000 a year — and if they smoke during treatment will end up spending more.

“In addition to treating cancer, we need to consider smoking, a health behavior, as not only an important health issue but a cost issue,” said Graham W, Warren, the study’s lead author, who works as an oncologist and professor at the university.

Warren and his team analyzed data from the 2014 surgeon general’s report on the health consequences of smoking to look at how treatment-failure rates and treatment costs from additional interventions compared between smokers and nonsmokers.

They found that patients who smoked had higher failure rates for their first-line cancer treatment than nonsmokers. That was true regardless of the severity of the cancer, though smoking posed the greatest risk for treatment failure among patients with cancers with high cure rates.

For example, a cancer with a 30 percent treatment failure rate for nonsmokers had a 40.7 percent failure rate for patients who smoked.

Researchers estimated that for a cohort of 1,000 patients with a 20 percent smoking rate — meaning about 200 were smokers — additional treatment after their first approach failed would cost a total of $2.1 million, or about $10,678 per smoking patient.

Though the connection between smoking, poor health outcomes, and high cost is clear, cessation resources are often limited for cancer patients, wrote Cara Petrucci and Andrew Hyland of the Roswell Park Comprehensive Cancer Center in Buffalo, N,Y., in an invited response to the study, also published in JAMA.

Insurance coverage for smoking cessation interventions is often limited, and oncologists specialized in treating cancer may not be equipped to also tackle an ingrained habit such as smoking.

How to better integrate smoking cessation — and who will pay for it — are issues that warrant more attention.

“The future of health care is focused on value-based medicine and providing the best care at the lowest cost. It will become increasingly important for clinicians and organizations to be able to accurately identify and analyze both the clinical and the financial consequences of health care and public health interventions,” they wrote.