The Biologic Effects of Cigarette Smoke on Cancer Cells

Smoking is one of the largest preventable risk factors for developing cancer, and continued smoking by cancer patients is associated with increased toxicity, recurrence, risk of second primary cancer, and mortality. Cigarette smoke (CS) contains thousands of chemicals, including many known carcinogens. The carcinogenic effects of CS are well established, but relatively little work has been done to evaluate the effects of CS on cancer cells. In this review of the literature, the authors demonstrate that CS induces a more malignant tumor phenotype by increasing proliferation, migration, invasion, and angiogenesis and by activating prosurvival cellular pathways. Significant work is needed to understand the biologic effect of CS on cancer biology, including the development of model systems and the identification of critical biologic mediators of CS-induced changes in cancer cell physiology. Cancer 2014;120:3617-3626. (c) 2014 American Cancer Society. Although the 2014 Surgeon General's Report The Health Consequences of Smoking50 Years of Progress concluded that smoking causes adverse outcomes and increases cancer-specific mortality, there is relatively little information on the biologic effects of cigarette smoke on cancer cells. This review summarizes the known effects of active cigarette smoke exposure on cancer cell biology linking cigarette smoke exposure to a prosurvival cancer cell phenotype.