Findings from a large smoking cessation study in patients with cancer indicate comprehensive tobacco treatment is effective in helping individuals successfully quit and abstain from smoking. The prospective study, published by Paul Cinciripini, PhD, Chair of Behavioral Science at the MD Anderson Cancer Center and Director of the Tobacco Treatment Program, and colleagues in JAMA Network Open, analyzed 3,245 smokers treated in a Tobacco Treatment Program at MD Anderson between 2006 and 2015.1
Paul Cinciripini, PhD
“Patients deserve the absolute best opportunity we can give them to quit smoking,” said Dr. Cinciripini. In a statement issued by MD Anderson, Dr. Cinciripini added, “Based on our data, we recommend offering comprehensive smoking cessation to patients [with cancer] as a clinical standard of care.”
Smoking Abstinence Rates
The investigators reported that at 3-, 6-, and 9-month follow-ups, smoking abstinence rates averaged 45%, 46%, and 44%, respectively. Based on the program’s success, the authors advocate for full integration of comprehensive tobacco treatment into the oncologic setting to ensure the best possible cancer treatment outcomes.
The study was not designed as a randomized clinical trial and did not compare different types of smoking cessation programs. Further, abstinence rates for the Tobacco Treatment Program were self-reported and were not regularly biochemically verified. Nevertheless, past studies of quitlines or other minimal interventions have resulted in abstinence rates of 20% or less.
MD Anderson’s program provides personalized tobacco treatment to nearly 1,200 new patients every year. Since 2013, patients have been automatically referred to the program through an electronic questionnaire used in all institutional clinics.
Program Includes Counseling and Medication Management
Program staff contact every new patient who self-identifies as a smoker. Most patients who agree to participate in the comprehensive program receive both intensive counseling and proactive medication management.
Maher Karam-Hage, MD
"We tailor nicotine replacement therapy, non-nicotine medications, and combination of these as recommendations to each individual and provide support through behavioral counseling sessions over 8 to 12 weeks following their initial consultation,” said Maher Karam-Hage, MD, Professor of Behavioral Science at MD Anderson and Medical Director of the Tobacco Treatment Program and a study coauthor. “Through this combined approach, we’ve seen effective results in cessation and abstinence.”
At MD Anderson, the average cost per quit ranges from $1,900 to $2,500. Participants receive treatment services for free, as the Tobacco Treatment Program is funded primarily through Texas Tobacco Settlement Funds awarded through the Tobacco Master Settlement. The authors noted that this funding arrangement is progressive and could serve as a model for other states.
DISCLOSURE: Drs. Cinciripini and Karam-Hage have received grant support and medication from Pfizer to conduct smoking cessation trials and have participated in two multisite trials sponsored by Pfizer. This study received funding support from the State of Texas Tobacco Settlement funds and from MD Anderson’s Cancer Center Support Grant (CA016672).
1. Cinciripini PM, Karam-Hage M, Kypriotakis G, et al: Association of a comprehensive smoking cessation program with smoking abstinence among patients with cancer. JAMA Netw Open 2:e1912251, 2019.