• Smoking is linked to an increased risk of lymphoma.
• Tobacco smoking can damage DNA and weaken the immune system.
• If you have lymphoma and smoke, the combination can lead to a poor outcome.

Research from the European Journal of Cancer Prevention shows that cigarette smoking is a risk factor for lymphoma, particularly Hodgkin lymphoma (HL) and T-cell non-Hodgkin lymphoma (NHL). Smoking is associated with numerous health risks, and depending on how much someone has smoked, it can increase the risk of lymphoma by as much as 45 percent.

Lymphoma is a group of blood cancers that affect the body’s lymph nodes and lymphatic system, which is part of the immune system. Among other adverse effects, smoking is known to weaken the immune system. There are many subtypes of lymphoma, which are all caused by cellular mutations that can be hereditary, due to aging, or from environmental exposures such as smoking. NHL is the most common type of lymphoma, while HL (also called Hodgkin disease) is considered rare.

How Smoking Increases the Risk of Cancer

Tobacco smoke contains thousands of chemicals from burning tobacco leaves and additives mixed with tobacco products, including cigarettes, cigars, and pipe tobacco. At least 70 of the chemicals found in tobacco smoke are known carcinogens — substances that cause cancer — particularly lung cancer. Smokeless tobacco products such as snuff, chewing tobacco, and e-cigarettes (vaping) are also linked to cancer.

The association of smoking with cancer was discovered in the 1960s. Scientists learned that carcinogens found in tobacco smoke could bind with DNA in cells. DNA is a molecule found in most cells and contains genetic coding that serves as a blueprint for cells to function properly. Toxic chemicals found in cigarettes can damage or disrupt DNA and produce mutations (changes) that can cause cancer.

Smoking and an Increased Risk of Lymphoma

Epidemiology research looks at factors such as incidence (new cases of disease in a population over a specific period of time) and patterns in disease. This type of research often analyzes risks associated with smoking by the number of cigarettes someone has smoked and for how long (pack-years), along with factors such as age or sex.

Risks of Hodgkin Lymphoma and Smoking

In one extensive cohort study with more than 478,000 participants, in which 1,371 participants had lymphoma, the risk for developing HL among people who smoke was found to be twice as high as the general population. This study was cited in the American Journal of Epidemiology and did not indicate an increased risk of NHL and B-cell NHL subtypes.

The risk for HL applied to people who had ever smoked, people who currently smoke, and those who used to smoke. Men were found to have a slightly higher risk than women.

Risks of Non-Hodgkin Lymphoma and Smoking

Another study from Cancer Epidemiology, Biomarkers & Prevention with more than 6,200 participants also showed that smoking was not associated with an increased risk of NHL. However, some research has indicated otherwise.

A study from the European Journal of Cancer prevention with more than 1.5 million people who smoke cigarettes showed that cigarette smoking increased the risk of T-cell NHL by approximately 30 percent. The study indicated that more research is needed on smoking and the risk of NHL subtypes.

Smoking and Follicular Lymphoma

Another recent oncology study showed that smoking substantially increased the risk of developing follicular lymphoma (FL), a subtype of NHL. A significant finding was that children who were exposed to secondhand smoke from households with two or more people who smoked were almost twice as likely to develop FL as those who never smoked or those not exposed to secondhand smoke. People who smoked had a risk of developing FL that was approximately 20 percent higher than those who had never smoked.

One study from Science Daily showed that smoking may increase the risk of FL developing into diffuse large B-cell lymphoma (DLBCL), which is a more aggressive form of lymphoma. DLBCL is a more lethal (likely to cause death) form of lymphoma and is associated with FL.

Smoking Worsens Lymphoma Prognosis

Aside from increasing the risk of developing lymphoma, smoking can also affect the overall survival of those with lymphoma. Research from the journal Blood has shown that people who smoke after a diagnosis of NHL, who were younger than 60 years old, had between a 1.8 and 2.5 greater risk of reduced life expectancy, depending on how much they smoked.

People who used to smoke also had a higher risk of lower life expectancy. The risk for those who used to smoke decreased the longer they had stopped smoking before an NHL diagnosis.

The Hazards of Smoking With Cancer

Smoking with cancer is linked to poorer outcomes, despite treatment. For people who smoke and have cancer (or as cancer survivors), smoking increases the risk of dying prematurely. Other risks of smoking with cancer include:

• Higher risk of developing other types of cancer
• Increased risk of cancer returning
• Higher risk of weakened treatment response and adverse reactions from treatment

The Benefits of Quitting Smoking

Stopping smoking has numerous health benefits for people with lymphoma and can help boost overall well-being. The U.S. Surgeon General has reported that smoking is a public health hazard that damages almost every organ in the body. Quitting smoking is critical for improved health and quality of life. The National Cancer Institute has determined that any smoking habit or use of tobacco is unsafe.

Quitting smoking helps prevent cancer and reduces the risk of many medical conditions, some of which are related to lymphoma, including:

• Cardiovascular disease, including hypertension, heart attack, and stroke
• Chronic obstructive pulmonary disease (COPD)
• Diabetes

Ask for Support

The U.S. Food and Drug Administration (FDA) website lists many resources to help you or a loved one quit smoking and tobacco use. The Truth Initiative has an online platform designed in collaboration with the Mayo Clinic to help people stop smoking and vaping through tools that you can access on your computer or smartphone. Your health care providers can also provide support to help you stop smoking. Talk to your doctor to determine if a nicotine patch might be right for you, or if you might benefit from a referral for a counselor.

MyLymphomaTeam members have shared their efforts to quit smoking. “I smoked many years ago and must have quit 100 times. All it takes is that last try, so hang in there and don’t give up. Your health will immediately start getting better, and eventually, you’ll look back on it and be grateful the addiction is in the past,” a member wrote.

Talk With Others Who Understand

On MyLymphomaTeam, the social network for people with lymphoma and their loved ones, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Do you still have questions about the risks associated with smoking? Do you have tips for quitting? Share your questions or experiences in the comments below, or start a conversation by posting on your Activities page.