Tools- of Changes

Effect of Smoking Cessation Counseling by Telephone and Provision of Medication on Smoking Abstinence in Patients Recently Diagnosed with Cancer

In this randomized clinical trial of 303 patients, conducted at 2 National Cancer Institute designated Comprehensive Cancer Centers, sustained telephone counseling over 6 months and provision of free medication compared with 4-week telephone counseling and medication advice resulted in 6-month biochemically confirmed quit rates of 34.5% vs 21.5%, a difference that was statistically significant. Among patients recently diagnosed with cancer, sustained cessation counseling and free medication may increase the likelihood of smoking abstinence compared with shorter-term counseling, but the generalizability of the study findings is uncertain and requires further research. Published in 2020.

Objective To determine the effectiveness of sustained telephone counseling and medication (intensive treatment) compared with shorter-term telephone counseling and medication advice (standard treatment) to assist patients recently diagnosed with cancer to quit smoking.

Design, Setting, and Participants This unblinded randomized clinical trial was conducted at Massachusetts General Hospital/Dana-Farber/Harvard Cancer Center and Memorial Sloan Kettering Cancer Center. Adults who had smoked 1 cigarette or more within 30 days, spoke English or Spanish, and had recently diagnosed breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma, or melanoma cancers were eligible. Enrollment occurred between November 2013 and July 2017; assessments were completed by the end of February 2018.

Interventions Participants randomized to the intensive treatment (153 people) and the standard treatment (150 people) received 4 weekly telephone counseling sessions and medication advice. The intensive treatment group also received 4 biweekly and 3 monthly telephone counseling sessions and choice of Food and Drug Administration-approved cessation medication (nicotine replacement therapy, bupropion, or varenicline).

Main Outcome and Measures The primary outcome was biochemically confirmed 7-day point prevalence tobacco abstinence at 6-month follow-up. Secondary outcomes were treatment utilization rates. 

Results Among 303 patients who were randomized (mean age, 58.3 years; 170 women [56.1%]), 221 (78.1%) completed the trial. Six-month biochemically confirmed quit rates were 34.5% in the intensive treatment group vs 21.5% in the standard treatment group.