Long-term, Frequent Phone Counseling Helps Cancer Patients Quit Smoking

Patients recently diagnosed with cancer are significantly more likely to quit smoking and remain tobacco-free if they receive frequent phone counseling over an extended period of time, according to a study published in JAMA. These results provide hope that patients who have recently been diagnosed with cancer may respond successfully to treatment while maintaining a higher quality of life during treatment.

Prior studies have demonstrated that between 10% and 30% of patients with cancer who smoke before diagnosis continue smoking after diagnosis. Additionally, studies have shown that approximately 50% of patients who quit smoking quickly relapse.

Following diagnosis, patients with cancer are not routinely recommended to pursue treatment in a smoking-cessation program, said lead study author Elyse R. Park, PhD, MPH, director of behavioral sciences at Massachusetts General Hospital’s Tobacco Research and Treatment Center, in a press release.

Additionally, Park explained that many physicians may be reluctant to discuss smoking cessation or may only recommend it for those patients who have a smoking-related cancer, such as lung cancer. However, smoking can make cancer treatment less effective and can diminish quality of life for patients during treatment, regardless of cancer type.

"Cancer patients need help in order to achieve the best cancer treatment outcomes," Park said in the press release.

According to the CDC, fewer than 10% of people who attempt to quit smoking succeed, which makes smoking cessation programs beneficial to supporting successful outcomes. However, telephone counseling administered by certified tobacco treatment counselors are often short-term and focused on cancer prevention. For this reason, the research team was interested in a program that would be more long-term in support of sustained cessation and improved quit rates for patients.

In the study, 303 patients with various forms of cancer were split into 2 groups. The first group received phone calls from counselors 4 times a week for a month, at which time the counselors would provide evidence-based behavioral strategies to help motivate patients in tobacco abstinence and stress management for the cancer diagnosis. This group also received advice regarding smoking cessation aids, such as nicotine-replacement therapy.

In the second group, the patients received a similar amount of phone counseling with the addition of 4 sessions every other week for 2 months, as well as 3 monthly booster sessions. These patients received free smoking-cessation medications.

After 6 months of treatment in these programs, the researchers found that 34.5% of patients in the second program successfully stayed tobacco free, compared with 21.5% of patients in the shorter, first program who received less frequent counseling.

"We believe it was the ongoing, positive cessation support, in coordination with the oncology care these patients received, that led to the high success rate in the intensive-treatment group," Park said in the press release.

Following these results, the research team implemented the second, more intensive tobacco treatment program at more than 40 community cancer centers around the United States.

"This randomized trial demonstrated that tobacco treatment can and should be an integral part of comprehensive cancer care," Park said in the press release. "Cessation advice and support should start immediately, at the time of diagnosis, and it should be offered to all cancer patients, regardless of tumor type and stage of disease."

REFERENCE

Long-term, frequent phone counseling helps cancer patients who smoke quit. Boston, MA: Massachusetts General Hospital; October 13, 2020. eurekalert.org/pub_releases/2020-10/mgh-lfp100920.php. Accessed October 29, 2020.