Preventing smoking relapse in patients with cancer: A randomized controlled trial

Simmons, Vani N.; Sutton, Steven K.; Meltzer, Lauren R.; Martínez, Úrsula Faura; Palmer, Amanda; Meade, Cathy D.; Jacobsen, Paul B.; McCaffrey, Judith C.; Haura, Eric B.; Brandon, Thomas H.

doi:10.1002/cncr.33162

Cited by 16 publications

(33 citation statements)

References 39 publications

(59 reference statements)

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“… 38 , 39 Thus, messaging around smoking cessation and smoking relapse prevention programs for cancer populations must be tailored to this population’s unique psychosocial needs and concerns relative to other populations. 40 , 41 …”

Section: Discussionmentioning

confidence: 99%

Smoking Is Related to Worse Cancer-related Symptom Burden

et al. 2022

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Background Cigarette smoking is related to greater cancer incidence, worse cancer-related clinical outcomes, and worse patient quality of life. Few studies have evaluated the role of smoking in patients’ experiences of cancer-related symptom burden. This study examined relationships between smoking and total symptom burden as well as the incidence of severe symptoms among adult cancer patients. Patients and Methods Patients at Moffitt Cancer Center completed self-report surveys as part of routine cancer care. Symptom burden was evaluated as the sum of individual symptom ratings (total symptom burden) and the number of symptoms rated severe (incidence of severe symptoms). Zero-inflated negative binomial modeling was used to evaluate the relationships between smoking status (ever vs never smoker) and symptom burden outcomes controlling for relevant sociodemographic and clinical covariates and accounting for the proportion of participants reporting no symptom burden. Results This study included 12 571 cancer patients. More than half reported a history of cigarette smoking (n = 6771, 55%). Relative to never smokers, participants with a smoking history had 15% worse expected total symptom burden (ratio = 1.15, 95% confidence interval [CI] 1.11-1.20, P < .001) and 13% more expected severe symptoms (ratio = 1.13, 95% CI 1.05-1.21, P = .001) above and beyond the effects of relevant sociodemographic and clinical characteristics. Conclusion Results provide support that smoking is associated with worse cancer symptom burden. More research is needed to evaluate how smoking history (ie, current vs former smoker) and smoking cessation influence cancer symptom burden.

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Section: Discussionmentioning

confidence: 99%

Smoking Is Related to Worse Cancer-related Symptom Burden

et al. 2022

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Section: Resultsmentioning

confidence: 99%

“…Geographically we report 23 studies from five countries ( Table 1 ), the majority from the USA [ 26 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], and Canada [ 24 , 47 , 48 ]. We report evidence from England [ 49 ], Lebanon [ 50 ] and Australia [ 51 ], and Nine studies report evidence from experimental randomised controlled trials [ 26 , 31 , 35 , 37 , 38 , 42 , 45 , 46 , 50 ]. Evidence is included from observational studies, namely cohort [ 24 , 33 , 34 , 43 , 48 ] and cross-sectional studies [ 44 , 47 ]; from mixed methods studies [ 32 , 40 , 51 ], quality improvement studies [ 36 , 39 , 41 ], and a qualitative study [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Smoking Cessation Interventions for Smokers Diagnosed with Cancer

Frazer

Bhardwaj

Fox

et al. 2022

IJERPH

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The detrimental impact of smoking on health and wellbeing are irrefutable. Additionally, smoking is associated with the development of cancer, a reduction treatment outcomes and poorer health outcomes. Nevertheless, a significant number of people continue to smoke following a cancer diagnosis. Little is understood of the smoking cessation services provided to smokers with cancer or their engagement with them. This systematic review aimed to identify existing smoking cessation interventions for this cohort diagnosed with breast, head and neck, lung and cervical cancers (linked to risk). Systematic searches of Pubmed, Embase, Psych Info and CINAHL from 1st January 2015 to 15th December 2020 were conducted. Included studies examined the characteristics of smoking cessation interventions and impact on referrals and quit attempts. The impact on healthcare professionals was included if reported. Included studies were restricted to adults with a cancer diagnosis and published in English. No restriction was placed on study designs, and narrative data synthesis was conducted due to heterogeneity. A review protocol was registered on PROSPERO CRD 42020214204, and reporting adheres to PRISMA reporting guidelines. Data were screened, extracted in duplicate and an assessment of the quality of evidence undertaken using Mixed Methods Assessment Tool. 23 studies met the inclusion criteria, representing USA, Canada, England, Lebanon, Australia and including randomized controlled trials (9), observational studies (10), quality improvement (3), and one qualitative study. Hospital and cancer clinics [including a dental clinic] were the settings for all studies. 43% (10/23) of studies reported interventions for smokers diagnosed with head and neck cancer, 13% (3/23) for smokers diagnosed with lung cancer, one study provides evidence for breast cancer, and the remaining nine studies (39%) report on multiple cancers including the ones specified in this review. Methodological quality was variable. There were limited data to identify one optimal intervention for this cohort. Key elements included the timing and frequency of quit conversations, use of electronic records, pharmacotherapy including extended use of varenicline, increased counselling sessions and a service embedded in oncology departments. More studies are required to ensure tailored smoking cessation pathways are co-developed for smokers with a diagnosis of cancer to support this population.

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“…For smoking status, a post hoc adjustment [ 58 ] will be applied to implement an influence of Missing Not at Random (MNAR) (ie, missing is due to smoking). In recent publications [ 59 ], we have applied a small to medium effect size (Cohen d =0.35). This approach provides better parameter estimates and tests of hypotheses than does imputing missing equals smoking.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the Efficacy of a Smoking Cessation Intervention for Cervical Cancer Survivors and Women With High-Grade Cervical Dysplasia: Protocol for a Randomized Controlled Trial

Jones¹,

Vidrine²,

Wetter³

et al. 2021

JMIR Res Protoc

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Background The prevalence of smoking among cervical cancer survivors is strikingly high, yet no smoking cessation interventions to date have specifically targeted this population. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial designed to evaluate the efficacy of a theoretically and empirically based Motivation And Problem Solving (MAPS) approach for promoting and facilitating smoking cessation among cervical cancer survivors. MAPS is a comprehensive, dynamic, and holistic intervention that incorporates empirically supported cognitive behavioral and social cognitive theory–based treatment strategies within an overarching motivational framework. MAPS is designed to be appropriate for all smokers regardless of their motivation to change and views motivation as dynamically fluctuating from moment to moment throughout the behavior change process. Objective This 2-group randomized controlled trial compares the efficacy of standard treatment to MAPS in facilitating smoking cessation among women with a history of high-grade cervical dysplasia or cervical cancer. Methods Participants (N=202) are current smokers with a history of high-grade cervical dysplasia or cervical cancer recruited nationally and randomly assigned to one of two treatment conditions: (1) standard treatment (ST) or (2) MAPS. ST consists of repeated letters referring participants to their state’s tobacco cessation quitline, standard self-help materials, and free nicotine replacement therapy when ready to quit. MAPS has all ST components along with 6 proactive telephone counseling sessions delivered over 12 months. The primary outcome is abstinence from tobacco at 18 months. Secondary outcomes include abstinence over time across all assessment points, abstinence at other individual assessment time points, quit attempts, cigarettes per day, and use of state quitlines. Hypothesized treatment mechanisms and cost-effectiveness will also be evaluated. Results This study was approved by the institutional review boards at the University of Texas MD Anderson Cancer Center, the University of Oklahoma Health Sciences Center, and Moffitt Cancer Center. Participant enrollment concluded at Moffitt Cancer Center in January 2020, and follow-up data collection was completed in July 2021. Data analysis is ongoing. Conclusions This study will yield crucial information regarding the efficacy and cost-effectiveness of a MAPS approach for smoking cessation tailored to the specific needs of women with a history of high-grade cervical dysplasia or cervical cancer. Findings indicating that MAPS has substantially greater efficacy than existing evidence-based tobacco cessation treatments would have tremendous public health significance. Trial Registration ClinicalTrials.gov NCT02157610; https://clinicaltrials.gov/ct2/show/NCT02157610 International Registered Report Identifier (IRRID) DERR1-10.2196/34502

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Preventing smoking relapse in patients with cancer: A randomized controlled trial

Cited by 16 publications

References 39 publications

Smoking Is Related to Worse Cancer-related Symptom Burden

Smoking Is Related to Worse Cancer-related Symptom Burden

Systematic Review of Smoking Cessation Interventions for Smokers Diagnosed with Cancer

Evaluation of the Efficacy of a Smoking Cessation Intervention for Cervical Cancer Survivors and Women With High-Grade Cervical Dysplasia: Protocol for a Randomized Controlled Trial

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