The Impact of Breast Reconstruction on Smoking Cessation Among Patients With Breast Cancer

BACKGROUND AND OBJECTIVES: In this study, we aim to evaluate trends in smoking cessation among breast cancer patients, with a particular focus on the impact of breast reconstruction surgery, and to assess if breast reconstruction surgery represents a unique opportunity for intervention. METHODS: We performed a retrospective analysis of active smokers with a new diagnosis of breast cancer who were treated with any surgical or non-surgical intervention at our institution between 2015 and 2024. Quitting was defined as continuous cessation for at least 30 days. Patients who quit were followed for at least 6 months after cessation. RESULTS: One hundred twenty-seven patients were identified. Mean age was 56 years (range 35-87). Eighty patients (63%) underwent surgery without reconstruction, 26 patients (20%) underwent surgery with reconstruction, and 21 patients (17%) received non-surgical treatment only. Overall, 26% (34/127) of patients quit smoking. Among patients undergoing surgical treatment, patients undergoing reconstruction were significantly more likely to quit smoking than those without reconstruction (50% [13/26] vs. 23% [18/80]; p = 0.007). Patients receiving reconstruction were also significantly more likely to quit preoperatively (77% [10/13] vs. 33% [12/18]; p = 0.048). Median time from initial visit with surgical oncology to surgery was longer among reconstructive patients who quit pre-operatively (90.5 days [IQR: 44-164]) than those who quit post-operatively or did not quit (45 days [IQR: 26-68]; p = 0.13). CONCLUSIONS: Patients receiving breast reconstruction are significantly more likely to quit smoking than those who do not. Longer median time to surgery among patients who quit pre-operatively emphasizes the need for targeted cessation interventions that allow for timely oncologic care.