Proceedings of a Workshop

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This activity was supported by Contract No. 75D30121D11240 (Task Order Nos. 75D30121F00002 and 75D30123F00024) and Contract No. 75N98024D00037 (Task Order No. 75N98025F00002) with the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health, respectively, and by the American Association for Cancer Research; American Cancer Society; American College of Radiology; American Society of Clinical Oncology; Association of American Cancer Institutes; Association of Cancer Care Centers; Cancer Center at Illinois; Flatiron Health; Merck; National Comprehensive Cancer Network; Novartis Oncology; Oncology Nursing Society; Partners In Health; Patient Advocate Foundation; and Pfizer Inc. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978–0-309-60011-8
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2025. Addressing the impact of tobacco and alcohol use on cancer-related health outcomes: Proceedings of a workshop. Washington, DC: National Academies Press. https://doi.org/10.17226/29264.

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WORKSHOP PLANNING COMMITTEE

S. GAIL ECKHARDT (Co-Chair), Baylor College of Medicine

ROY S. HERBST (Co-Chair), Yale University; American Association for Cancer Research

GWEN DARIEN, Patient Advocate Foundation

SCARLETT LIN GOMEZ, University of California, San Francisco

CHANITA HUGHES-HALBERT, University of Southern California

FARHAD ISLAMI, American Cancer Society

ROY A. JENSEN, University of Kansas; Association of American Cancer Institutes

ELENA MARTÍNEZ, University of California San Diego

NIGAR NARGIS, American Cancer Society

LISA RICHARDSON, Centers for Disease Control and Prevention

DEIDRA ROACH, National Institute on Alcohol Abuse and Alcoholism

KATRINA TRIVERS, Centers for Disease Control and Prevention

Project Staff

ANNA ADLER, Research Associate (from June 2025)

TORRIE BROWN, Program Coordinator

MAKEDA HAUGHTON, Senior Program Assistant (from December 2024)

EMMA WICKLAND, Research Associate (through May 2025)

JULIE WILTSHIRE, Senior Finance Business Partner

JENNIFER ZHU, Associate Program Officer

FRANCIS AMANKWAH, Director, National Cancer Policy Forum

SHARYL NASS, Senior Director, Board on Health Care Services

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NATIONAL CANCER POLICY FORUM

ROBERT A. WINN (Chair), Virginia Commonwealth University

ROHIT BHARGAVA, Cancer Center at Illinois

SMITA BHATIA, The University of Alabama at Birmingham

GIDEON BLUMENTHAL, Merck

CHRIS BOSHOFF, Pfizer Inc.

CHRISTINA CHAPMAN, Baylor College of Medicine; Michael E. DeBakey VA Medical Center

GWEN DARIEN, Patient Advocate Foundation

CRYSTAL DENLINGER, National Comprehensive Cancer Network

JAMES H. DOROSHOW, National Cancer Institute

S. GAIL ECKHARDT, Baylor College of Medicine

CHRISTOPHER R. FRIESE, University of Michigan

SCARLETT LIN GOMEZ, University of California, San Francisco

JULIE R. GRALOW, American Society of Clinical Oncology

SARAH GREENE, Independent Consultant; Patient Advocate

ROY S. HERBST, Yale University; American Association for Cancer Research

HEDVIG HRICAK, Memorial Sloan Kettering Cancer Center

CHANITA HUGHES-HALBERT, University of Southern California

ROY A. JENSEN, University of Kansas; Association of American Cancer Institutes

RANDY A. JONES, University of Virginia

BETH Y. KARLAN, University of California, Los Angeles

NANCY KEATING, Harvard Medical School

SAMIR N. KHLEIF, Georgetown University; Society for Immunotherapy of Cancer

RONALD M. KLINE, Centers for Medicare & Medicaid Services

SHIVAANI KUMMAR, Oregon Health & Science University

ELENA MARTÍNEZ, University of California San Diego

LARISSA NEKHLYUDOV, Brigham and Women’s Hospital; Dana-Farber Cancer Institute; Harvard Medical School

DONNA RIVERA, U.S. Food and Drug Administration

CLEO A. RYALS, Flatiron Health

SUSAN M. SCHNEIDER, Duke University

LAWRENCE N. SHULMAN, University of Pennsylvania

MICHELLE SIDEL, Novartis Pharmaceuticals

AMYE J. TEVAARWERK, Mayo Clinic

KATRINA TRIVERS, Centers for Disease Control and Prevention

ROBIN YABROFF, American Cancer Society

Forum Staff

ANNA ADLER, Research Associate

TORRIE BROWN, Program Coordinator

MAKEDA HAUGHTON, Senior Program Assistant

JULIE WILTSHIRE, Senior Finance Business Partner

JENNIFER ZHU, Associate Program Officer

FRANCIS AMANKWAH, Director, National Cancer Policy Forum

SHARYL NASS, Senior Director, Board on Health Care Services

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by PATRICIA GANZ, University of California, Los Angeles. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

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Acknowledgments

The National Cancer Policy Forum is grateful for the support of its many annual sponsors. Federal sponsors include the Centers for Disease Control and Prevention and National Cancer Institute/National Institutes of Health. Nonfederal sponsors include the American Association for Cancer Research, American Cancer Society, American College of Radiology, American Society of Clinical Oncology, Association of American Cancer Institutes, Association of Cancer Care Centers, Cancer Center at Illinois, Flatiron Health, Merck, National Comprehensive Cancer Network, Novartis Oncology, Oncology Nursing Society, Partners In Health, Patient Advocate Foundation, and Pfizer Inc.

The forum wishes to express its gratitude to the expert speakers whose presentations and discussions helped inform a deeper understanding of the effects of both tobacco and alcohol and their synergistic effects on cancer incidence and outcomes, education on the impacts of alcohol and tobacco, and the development of clinical guidelines for patients with cancer to mitigate the risks of alcohol and tobacco use. The forum also wishes to thank the members of the planning committee for their work in developing an excellent workshop agenda.

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Contents

ACRONYMS AND ABBREVIATIONS

PROCEEDINGS OF A WORKSHOP

Workshop Overview

Overview of Research on the Impact of Tobacco and Alcohol Use on Cancer-Related Health Outcomes

Current Policy Strategies to Reduce Tobacco and Alcohol Use

Messaging and Marketing of Tobacco and Alcohol Products

Prevention, Cessation, and Reduction Efforts

Challenges and Opportunities to Reduce Tobacco- and Alcohol-Related Cancer Risk

Closing Thoughts

REFERENCES

APPENDIXES

A Statement of Task

B Workshop Agenda

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Boxes and Figure

BOXES

1 Observations from Individual Workshop Participants on the Effects of Tobacco and Alcohol Use on Cancer-Related Health Outcomes

2 Suggestions from Individual Workshop Participants to Lower Cancer Risk and Improve Health Outcomes by Reducing Tobacco and Alcohol Use

3 A Perspective on Why Tobacco Control Efforts Have Been Effective

4 Lessons from a State with High Smoking Prevalence

FIGURE

1 U.S. cigarette consumption, 1900–2020

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Acronyms and Abbreviations

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