Tobacco Use and Outcomes in Gynecologic Malignancy

Tobacco use remains a significant cause of morbidity and mortality worldwide. Tobacco contains many carcinogens as well as nicotine, which contributes to the development of multiple malignancies. In addition to malignancies of the head and neck, several gynecologic malignancies have been associated with tobacco use including cervical, vulvar, and vaginal cancers. Additionally, tobacco is associated with worse prognosis and increased rate of complications in gynecologic cancer patients of all disease sites. Recent literature in the area of tobacco use and gynecologic malignancy is highlighted in this review including tobacco’s association with treatment complications, secondary malignancy, and surgical complications. A focus is placed on tobacco cessation as a means to improve these outcomes. The use of automated referrals to reduce provider burden and targeting of the preoperative window are valuable strategies. Smoking cessation should be encouraged by oncologists and survivorship programs as a means to improve the health of women with gynecologic malignancy and reduce healthcare costs.