Strategies for tobacco control among youngsters with cancer.

OBJECTIVE To examine smoking rates, discuss risk factors for smoking onset, and summarize the success of smoking trials conducted to date with youngsters treated for cancer. METHODS Studies selected from the published pediatric literature on smoking in young cancer patients were summarized to illustrate the progress in tobacco control in this vulnerable population. RESULTS Children with cancer report smoking at rates that are lower than or comparable to those of their healthy peers, depending on their treatment status. The few smoking trials conducted with youngsters with cancer have yielded modest effects. CONCLUSIONS The timing, intensity and duration of smoking interventions for children with cancer in the medical setting have not been adequately explored. Identification of intermediate biomarkers that are predictive of later morbidity is necessary to demonstrate the short-term impact of smoking trials. Simultaneous implementation of many levels of intervention will enhance tobacco control efforts for youngsters with cancer.