Many patients with cancer continue to smoke, and many also live with pain. A pilot study now reports that a treatment pairing the smoking-cessation drug varenicline with a behavioral program targeting both smoking and pain helped a small group of patients with cancer quit, with most participants rating the approach as helpful and roughly one in three achieving biochemically confirmed abstinence at six months.
The study, published in the Journal of Cancer Survivorship, was a single-arm pilot trial, meaning every participant received the same combined intervention and there was no control group for comparison. The researchers recruited 19 patients with cancer and provided varenicline alongside a four-session behavioral treatment designed to use the same techniques to help people stop smoking and manage their pain. The primary outcome was seven-day point prevalence abstinence, a standard measure asking whether a participant has smoked at all during the seven days before assessment, evaluated six months after randomization.
Because the trial was small and uncontrolled, the results are preliminary rather than definitive. Among the 17 patients with available data, six, or 35 percent, reported abstinence that was biochemically validated at the six-month mark.
Acceptability emerged as a clear strength. Among patients who received the intervention, 80 percent rated it as helpful, four or five on a five-point scale, for helping them quit smoking, and 60 percent rated it as helpful for managing their pain. Even more striking, 94 percent said they would recommend the program to other patients with cancer.
The pain side of the intervention showed a more mixed picture. The researchers did not observe improvements in patients’ reported pain levels, but they did see gains in pain self-efficacy, a measure of how confident people feel in their ability to manage pain on their own. The authors note that aspects of the pain component need refinement before the approach can be expected to move pain outcomes.
The behavioral treatment was built around a deliberate design choice: rather than treating smoking and pain as separate problems requiring separate clinics, it applies the same techniques to both.
The authors are explicit that the next step is a large randomized controlled trial to fully test the efficacy of the combined behavioral program with varenicline. A pilot of 19 patients cannot establish efficacy, and the absence of a control arm means abstinence rates might partly reflect factors unrelated to the treatment.
For cancer survivors who smoke, the practical takeaway is that a combined smoking cessation and pain program paired with varenicline might help them quit, and that addressing pain alongside smoking may motivate more patients to join such a program in the first place. Larger trials will determine whether the promising abstinence rate holds and whether a refined pain component can deliver the pain relief that patients in this pilot did not experience.
Subject of Research: A pilot study of varenicline combined with a behavioral intervention for smoking cessation and pain management in patients with cancer
Article Title: Pilot study testing varenicline combined with a behavioral intervention for promoting smoking cessation and pain management among patients with cancer
Article References: Pollak, K. I., Davis, J. M., Fish, L. J., Sutton, L. M., Olsen, M. K., Owen, L., Hantzmon, S., Richardson, B., Alkon, A., & Somers, T. J. (2026). Pilot study testing varenicline combined with a behavioral intervention for promoting smoking cessation and pain management among patients with cancer. Journal of Cancer Survivorship. https://doi.org/10.1007/s11764-026-02147-6
Image Credits: AI Generated
DOI: 10.1007/s11764-026-02147-6
Keywords: varenicline, smoking cessation, cancer survivors, pain management, behavioral intervention, pilot study, pain self-efficacy, Journal of Cancer Survivorship, biochemically validated abstinence, randomized controlled trial, Pilot, testing
News Source: Nathaniel Bowman. (November 5, 2026). Varenicline plus behavioral therapy shows promise for smokers with cancer in pilot trial. Scienmag.
