Smoking Cessation Interventions in Cancer Care: Opportunities for Oncology Nurses and Nurse Scientists

Abstract

Smoking cessation is essential after the diagnosis of cancer to improve clinical outcomes. The purpose of this chapter is to provide a systematic review of research on smoking cessation in the context of cancer care with an emphasis on nursing contributions to the field. Data sources included research reports of smoking cessation interventions conducted in people with cancer. Nineteen primary studies were reviewed. High intensity interventions, targeting multiple behaviors, and/or using a multicomponent intervention that included pharmacotherapy, behavioral counseling, and social support were characteristics of the most successful treatments for tobacco dependence. The majority of interventions were conducted in adults with smoking-related malignancies during acute phases of illness. The most striking finding was that more than one half of the studies tested the efficacy of nurse-delivered interventions. Conceptual and methodological issues that can be improved in future studies include: using theoretical frameworks to specify how the intervention will affect outcomes, ensuring adequate sample sizes, using biochemical verification to monitor smoking outcomes, and using standardized outcome measures of abstinence. Although effective interventions are available for healthy populations, further research is needed to determine if tailored cessation interventions are needed for patients with cancer. To provide optimal quality care it is imperative that delivery of evidence-based smoking cessation interventions be integrated into the cancer treatment trajectory. Multiple barriers, including patient and nurse attitudes toward smoking and lack of knowledge related to tobacco treatment, prevent translating evidence-based tobacco dependence treatment into clinical practice. Further nursing research is needed to address these barriers.

Smoking Cessation Interventions and Cessation Rates in the Oncology Population: An Updated Systematic Review and Meta‐Analysis

“…Ten RCTs 5,15,16,[66][67][68][69][70][71][72] and 3 PC studies 21,73,74 met the inclusion criteria (Figure 1).…”

“…Studies were evaluated in 2 groups based on follow-up duration. The group with the shorter follow-up period (n = 6) had a mean follow-up of 5 weeks, 15,21,66,[68][69][70][71][72][73][74] and the longer follow-up group (n = 7) was followed for at least 6 months. 4,5,16,67 In the second group, pooled rates were calculated from the 6-month abstinence rates in all studies except 1, 4 which reported a 12-month rate ( Table 4).…”

Why do cancer patients smoke and what can providers do about it?

“…11,34,52–57 A table of studies evaluating smoking cessation interventions in cancer patients can be found in an article by Cooley and colleagues. 58 A review of the evidence follows.…”

Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers

“…Unfortunately, 15.1% of all cancer survivors report being current smokers [3]. At the time of diagnosis, estimated rates on the prevalence of current smoking vary greatly ranging from approximately 45–75% depending upon a number of factors including type of cancer [4]. For instance, continued smoking appears higher among patients diagnosed with tobacco-related cancers (27%) compared to other cancer survivors (16%) [5].…”

“…However, some smokers may be unable or unwilling to quit. Unfortunately, the few clinical interventions conducted have failed to produce significant outcomes [4, 30–35]. For those who continue to smoke following diagnosis, at least two interpretations are possible.…”