In a fresh push for better cancer research, experts from top institutions like AIIMS Delhi, McMaster University in Canada, and the International Agency for Research on Cancer in France are calling for mandatory recording of smoking status in all cancer clinical trials. This recommendation, detailed in a commentary published in The Lancet Oncology in August 2025, highlights how ongoing tobacco use can harm treatment results and lower patient survival rates, urging a shift in how trials handle this key factor.
The Urgent Call from Global Experts
A team of seven researchers, including Dr. Abhishek Shankar from AIIMS Delhi, made their case clear in the recent commentary. They stress that knowing a patient’s smoking habits during treatment is not just helpful but essential for making smart clinical choices.
This comes at a time when cancer rates are climbing worldwide. According to the World Health Organization’s latest 2025 data, tobacco use remains a top cause of cancer, linked to about 22 percent of all cancer deaths globally. The experts warn that ignoring smoking in trials could skew results and miss chances to help patients quit.
Their message builds on growing evidence from studies in 2025, such as one in Frontiers in Oncology that explored how smoking dose affects immunotherapy success in lung cancer patients.
The group points out that simple steps like tracking smoking could lead to personalized care plans. For instance, doctors might adjust therapies or add quit smoking support to boost outcomes.
Why Smoking Status Affects Cancer Treatment
Smoking does more than cause cancer; it can interfere with how well treatments work. Continued tobacco use during therapy may reduce the power of drugs, radiation, and surgery, leading to poorer results.
Research from the European Respiratory Society in June 2025 shows that smokers with lung cancer often have worse responses to immune checkpoint inhibitors, a common treatment. In one analysis of 17 trials, these therapies improved survival more in non smokers than in those who kept smoking.
Experts explain that tobacco smoke harms the body’s immune response and speeds up tumor growth. This makes it vital to record smoking status at the start of trials and during follow up visits.
In practical terms, this data could help spot patients who need extra support. Quitting smoking, even after a cancer diagnosis, can improve survival odds by up to 40 percent in some cases, based on recent observational studies.
The commentary also ties into broader trends. With global smoking rates still high at about 1.3 billion users in 2025, per WHO figures, integrating this info into trials could refine how we estimate treatment success.
Key Impacts on Patient Survival and Trial Outcomes
Failing to track smoking can lead to misleading trial data. Patients who smoke might show lower response rates, which could undervalue a treatment’s true potential for non smokers.
Here are some critical impacts highlighted by recent studies:
- Reduced efficacy: Smoking can cut the effectiveness of targeted therapies like EGFR inhibitors in lung cancer by as much as 30 percent, according to a 2025 meta analysis.
- Higher risks: Ongoing smoking raises complication rates during surgery and radiation, increasing mortality by 20 to 50 percent in various cancers.
- Survival gaps: Non smokers in trials often live longer, with one 2025 study showing a 42 percent higher chance of sustained recovery when smoking stops.
- Data accuracy: Recording status helps adjust for biases, leading to more reliable results that guide real world care.
These points show why experts see this as a game changer for oncology research.
Beyond survival, there’s an economic angle. Cancer treatments cost billions each year, and better data could save resources by focusing on what works best for different groups.
Barriers to Recording Smoking and How to Overcome Them
Despite the benefits, many trials skip detailed smoking assessments. Common hurdles include lack of standard protocols, time constraints in busy clinics, and patient reluctance to report habits.
The experts suggest embedding simple questions into trial designs, like asking about current use, pack years, and quit attempts. They also call for training staff on tobacco cessation support.
To illustrate potential solutions, consider this table of strategies based on recent recommendations:
| Barrier | Proposed Solution | Expected Benefit |
|---|---|---|
| No standard questions | Add mandatory smoking fields in trial forms | Consistent data collection across studies |
| Limited resources | Partner with quit smoking programs | Low cost way to boost patient support |
| Patient underreporting | Use anonymous surveys and biomarkers | More accurate tracking of habits |
| Follow up challenges | Schedule regular check ins | Better monitoring of changes over time |
Implementing these could make trials more effective and patient focused.
In places like India, where smoking rates are high among men at 28 percent per a 2025 survey, such changes could have a big local impact.
Experts note that some networks, like the National Cancer Institute’s Clinical Trials Network, have started assessing tobacco use more routinely since early 2025, setting a positive example.
Broader Implications for Cancer Care Worldwide
This push aligns with global efforts to fight tobacco. The WHO’s 2025 Framework Convention on Tobacco Control urges stronger links between smoking cessation and cancer management.
In lung cancer, where smoking causes 85 percent of cases, recording status could refine staging and prognosis, as seen in the IASLC’s ninth edition TNM classification update in August 2025.
Looking ahead, the experts hope this leads to policies requiring smoking data in all oncology trials. It could also inspire similar tracking for other lifestyle factors like diet and exercise.
As cancer cases are projected to rise 60 percent by 2040, per WHO estimates, these steps are timely. They offer a way to not only improve research but also empower patients to make changes that extend their lives.
What do you think about recording smoking in cancer trials? Share your views in the comments and spread this article to raise awareness.
