Objectives. To evaluate tobacco smoking cessation interventions and cessation rates in the oncology population through a systematic review and meta-analysis.Data Sources. The literature was searched using PubMed, Google Scholar, Medline, EMBASE, and the Cochrane Library (inception to October 2012) by 3 independent review authors.Review Methods. Studies were included if they were randomized controlled trials (RCTs) or prospective cohort (PCs) studies evaluating tobacco smoking cessation interventions with patients assigned to a usual care or an intervention group. The primary outcome measure was smoking cessation rates. Two authors extracted data independently for each study. When applicable, disagreements were resolved by consensus.Results. The systematic review identified 10 RCTs and 3 PCs. Statistical analysis was conducted using StatsDirect software (Cheshire, UK). Pooled odds ratios (ORs) for smoking cessation interventions were calculated in 2 groups based on follow-up duration. The therapeutic interventions included counseling, nicotine replacement therapy, buproprion, and varenicline. Smoking cessation interventions had a pooled odds ratio of 1.54 (95% confidence interval [CI], 0.909-2.64) for patients in the shorter follow-up group and 1.31 (95% CI, 0.931-1.84) in the longer follow-up group. Smoking cessation interventions in the perioperative period had a pooled odds ratio of 2.31 (95% CI, 1.32-4.07).
Conclusion.Our systematic review and meta-analysis demonstrate that tobacco cessation interventions in the oncology population, in both the short-term and long-term follow-up groups, do not significantly affect cessation rates. The perioperative period, though, may represent an important teachable moment with regard to smoking cessation. C igarette smoking and alcohol consumption synergistically increase the risk of developing squamous cell carcinoma of the head and neck.1,2 Tobacco carcinogens also further advance the molecular progression of squamous cell carcinomas of the head and neck.1,2 Cigarette smoking has been related to approximately 90% of diagnoses of lung cancer in countries with a high prevalence of smoking. Furthermore, the increased incidence of lung cancer from smoking is proportional to the length and intensity of smoking history.3 Smoking cessation is particularly important for patients who have smoking-related cancers, such as head and neck or lung cancer. 3,4 Persistent tobacco smoking in the oncology population has a multitude of adverse effects during the treatment of the malignancy, increases the risk of a recurrence or a second primary tumor, and reduces survival. 5,6 These risks are particularly apparent in patients with head and neck or lung cancer. Cigarette smoking also increases the perioperative risks of general anesthesia, poor wound healing, and cardiovascular events.
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