Smoking cessation

Avoid

9 studies · 1 recommendation

Last updated: February 27, 2026

Avoid9 studies

Quitting smoking reduces breast cancer risk and improves survival across all tumor subtypes

Nine studies spanning over 500,000 participants consistently link smoking to increased breast cancer risk and worse outcomes. A meta-analysis of 27 prospective studies established a 10-13% elevated risk for ever and current smokers (SRR 1.10-1.13, 95% CI 1.09-1.17) with zero heterogeneity. Case-control studies demonstrate a strong dose-response: women smoking 20+ cigarettes daily face 4.6 times higher odds (95% CI 2.2-9.7) compared to unexposed women. Among 121,435 breast cancer patients, current smokers had 37% higher all-cause mortality (HR 1.37, 95% CI 1.27-1.47) and 11% higher breast cancer-specific mortality regardless of tumor subtype. Male breast cancer patients who smoked showed over three-fold increased death risk (HR 3.34, 95% CI 1.45-7.68). Cumulative pack-years of exposure amplify risk, making smoking cessation at any point a meaningful intervention for both prevention and survival.

Evidence

A healthy lifestyle index and cancer: Using a multifactor lifestyle exposure to estimate cancer incidence and survival among Norwegian women

Authors: Chen, Sairah Lai Fa

Published: August 17, 2023

Among approximately 170,000 women in the Norwegian Women and Cancer Study, smoking was identified as particularly strong in driving associations between the Healthy Lifestyle Index and cancer incidence, including postmenopausal breast cancer. Women with higher HLI scores (which includes non-smoking as a component) had significantly lower risks of postmenopausal breast cancer. The study concluded that smoking avoidance should be a priority and promoted throughout all adult ages to reduce cancer risk in women.

View Source →

Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association ConsortiumBreast Cancer Risk Factors and Survival By Tumor Subtype

Authors: Ahearn, Thomas U, Anton-Culver, Hoda, Arndt, Volker, Augustinsson, Annelie, Auvinen, Päivi K, Becher, Heiko, Beckmann, Matthias W, Behrens, Sabine, Blomqvist, Carl, Bojesen, Stig E, Bolla, Manjeet K, Brenner, Hermann, Briceno, Ignacio, Brucker, Sara Y, Camp, Nicola J, Campa, Daniele, Canzian, Federico, Castelao, Jose E, Chanock, Stephen J, Choi, Ji-Yeob, Clarke, Christine L, Collaborators, for the NBCS, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Dunning, Alison M, Dwek, Miriam, Dörk, Thilo, Easton, Douglas F, Eccles, Diana M, Egan, Kathleen M, Evans, D Gareth, Fasching, Peter A, Flyger, Henrik, Freeman, Laura E Beane, Gago-Dominguez, Manuela, Gapstur, Susan M, García-Sáenz, José A, Gaudet, Mia M, Giles, Graham G, Grip, Mervi, Guénel, Pascal, Haiman, Christopher A, Hall, Per, Hamann, Ute, Han, Sileny N, Hart, Steven N, Hartman, Mikael, Heyworth, Jane S, Hoppe, Reiner, Hopper, John L, Hunter, David J, Håkansson, Niclas, Investigators, for the ABCTB, Ito, Hidemi, Jager, Agnes, Jakimovska, Milena, Jakubowska, Anna, Janni, Wolfgang, Jung, Audrey Y, Kaaks, Rudolf, Kang, Daehee, Kapoor, Pooja Middha, Keeman, Renske, Kitahara, Cari M, Koutros, Stella, Kraft, Peter, Kristensen, Vessela N, Lacey, James V, Lambrechts, Diether, Le Marchand, Loic, Li, Jingmei, Lindblom, Annika, Lubiński, Jan, Lush, Michael, Mannermaa, Arto, Manoochehri, Mehdi, Margolin, Sara, Mariapun, Shivaani, Matsuo, Keitaro, Mavroudis, Dimitrios, Milne, Roger L, Morra, Anna, Muranen, Taru A, Newman, William G, Noh, Dong-Young, Nordestgaard, Børge G, Obi, Nadia, Olshan, Andrew F, Olsson, Håkan, Park-Simon, Tjoung-Won, Petridis, Christos, Pharoah, Paul DP, Plaseska-Karanfilska, Dijana, Presneau, Nadege, Rashid, Muhammad U, Rennert, Gad, Rennert, Hedy S, Rhenius, Valerie

Published: April 1, 2021

Among 121,435 breast cancer patients from 67 pooled studies with 16,890 deaths over 10 years, current versus never smoking was associated with a hazard ratio of 1.37 (95% CI 1.27-1.47) for all-cause mortality and 1.11 (95% CI 1.02-1.21) for breast cancer-specific mortality. These associations did not differ significantly by ER status or intrinsic-like subtype (P adj > 0.30), confirming that smoking increases mortality risk regardless of tumor subtype.

View Source →

Smoking and FGFR2 rs2981582 variant independently modulate male breast cancer survival: A population-based study in Tuscany, Italy

Authors: Bendinelli, Benedetta, Bianchi, Simonetta, Magrini, Alessandro, Masala, Giovanna, Ottini, Laura, Palli, Domenico, Rizzolo, Piera, Saieva, Calogero, Silvestri, Valentina, Valentini, Virginia, Vezzosi, Vania, Zanna, Ines, Zelli, Veronica

Published: January 1, 2018

In a population-based cohort study of 166 male breast cancer cases in Tuscany, Italy, multivariate Cox regression analysis adjusted for clinico-pathological, lifestyle, and genetic factors demonstrated that current smokers had significantly worse 10-year overall survival compared to non-smokers. Current smokers showed a hazard ratio of 3.34 (95% CI: 1.45–7.68; p = 0.004), indicating more than three-fold increased risk of death. Sensitivity analysis with left truncation confirmed these findings. Smoking was the only modifiable lifestyle factor reaching statistical significance for survival outcomes in this well-characterized series.

View Source →

Relation of Breast Cancer with Passive and Active Exposure to Tobacco Smoke

Authors: Bemstein, Martine, Héritier, Stéphane, Khatchatrian, Naīra, Morabia, Alfredo

Published: August 2, 2017

A population-based case-control study in Geneva (244 breast cancer cases, 1,032 controls) compared women with active smoking exposure against those unexposed to both active and passive smoke. Adjusted odds ratios showed a clear dose-response: 2.2 (95% CI 1.0-4.4) for 1-9 cigarettes/day, 2.7 (95% CI 1.4-5.4) for 10-19 cigarettes/day, and 4.6 (95% CI 2.2-9.7) for 20+ cigarettes/day. Odds ratios were adjusted for known breast cancer risk factors including alcohol and saturated fat intake. No evidence of strong selection, detection, or recall biases was identified.

View Source →

Active and passive smoking and risk of breast cancer : a meta-analysis

Authors: Autier, Philippe, Boniol, Mathieu, Boyle, Peter, Macacu, Alina

Published: January 1, 2015

Meta-analysis of 27 prospective studies found ever active smoking associated with a summary relative risk (SRR) of 1.10 (95% CI 1.09-1.12) for breast cancer with no heterogeneity (I² = 0%). Current active smoking showed an SRR of 1.13 (95% CI 1.09-1.17) in 27 prospective studies. In 44 retrospective studies, ever active smoking SRR was 1.08 (95% CI 1.02-1.14) with I² = 59%. Results were consistent across subgroup analyses including menopausal status and alcohol adjustment, and whether passive smokers were included or excluded from the reference group.

View Source →

Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study

Authors: Andersson, Anne, Ardanaz, Eva, Baglietto, Laura, Buckland, Genevieve, Bueno-de-Mesquita, H. B(As), Chajes, Veronique, Dahm, Christina C., Dartois, Laureen, de Batlle, Jordi, Dossus, Laure, Ericson, Ulrika,, Ferrari, Pietro, Freisling, Heinz, Gunter, Marc, Key, Tim J., Krogh, Vittorio, Lagiou, Pagona, Lund University., Lund University., Lund University., May, Anne, McKenzie, Fiona, Navarro, Carmen, Overvad, Kim, Panico, Salvatore, Peeters, Petra H., Riboli, Elio, Rinaldi, Sabina, Romieu, Isabelle, Rosso, Stefano, Sanchez, Maria-Jose, Sund, Malin, Travis, Ruth C., Trichopoulos, Dimitrios, Trichopoulou, Antonia, Tumino, Rosario, Vergnaud, Anne-Claire, Weiderpass, Elisabete, Wirfält, Elisabet,

Published: November 16, 2014

In the EPIC cohort study of 242,918 postmenopausal women with 7,756 incident breast cancer cases over 10.9 years median follow-up, smoking was scored as one of five HLIS components (0-4, higher = healthier). The combined healthy lifestyle score showed that women in the fourth versus second category had significantly reduced breast cancer risk (adjusted HR = 0.74; 95% CI: 0.66-0.83). Each incremental point on the HLIS corresponded to a 3% lower breast cancer risk. Risk reductions were observed across breast cancer subtypes, including hormone receptor double negative (HR = 0.60, 95% CI: 0.40-0.90).

View Source →

Effects of lifestyle and single nucleotide polymorphisms on breast cancer risk: a case-control study in Japanese women

Authors: Doihara, Hiroyoshi, Ishibe, Youichi, Ishihara, Setsuko, Iwamoto, Takayuki, Kawai, Hiroshi, Kawasaki, Kensuke, Komoike, Yoshifumi, Matsuoka, Junji, Miyoshi, Shinichiro, Mizoo, Taeko, Motoki, Takayuki, Nishiyama, Keiko, Nogami, Tomohiro, Ogasawara, Yutaka, Shien, Tadahiko, Taira, Naruto

Published: December 1, 2013

In a case-control study of 472 breast cancer cases and 464 controls among Japanese women (December 2010–November 2011), current or former smoking was significantly associated with increased breast cancer risk in multivariate-adjusted logistic regression analysis (p < 0.05). The association persisted after controlling for age, BMI, dietary intake, physical activity, and reproductive factors. The study also found smoking interacted with SNP rs2046210 genotype, with high BMI and smoking effects varying by allele carrier status.

View Source →

OBESIDAD Y CANCER DE MAMA

Authors: Arceo Guzmán, Mario Enrique, De La Cruz Vargas, Jhony Alberto, Héctor Lorenzo, Ocaña Servín

Published: November 1, 2010

In a case-control study of 168 Mexican women (84 cases, 84 controls), tobacco consumption was identified as a risk factor for breast cancer with OR 1.9 (p<0.03), indicating approximately 90% higher odds of developing breast cancer among tobacco users compared to non-users.

View Source →

Risk factors for breast cancer in a population with high incidence rates.

Authors: Barlow, Janice, Belli, Flavia, Chew, Terri, Clarke, Christina, Erdmann, Christine A, Farren, Georgianna, Gould, Mary, Lee, Marion, Moghadassi, Michelle, Peskin-Mentzer, Roni, Quesenberry, Charles P, Souders-Mason, Virginia, Spence, Linda, Suzuki, Marisa, Wrensch, Margaret

Published: January 1, 2003

This case-control study comparing 285 breast cancer cases to 286 frequency-matched controls found that women in the highest quartile of pack-years of cigarette smoking were statistically significantly more likely to have breast cancer in multivariate analyses. Pack-years integrates both duration and intensity of smoking, suggesting cumulative tobacco exposure contributes to breast cancer risk. This finding supports smoking cessation and avoidance as a modifiable lifestyle factor for breast cancer prevention.

View Source →