Virtual sustained counseling and nicotine replacement therapy led to an almost doubling of 6-month smoking quit rates compared with standard care for patients facing a recent cancer diagnosis, according to findings from the randomized controlled ECOG-ACRIN EAQ171CD trial from the National Cancer Institute (NCI) Community Oncology Research Program, which was published in the Journal of Clinical Oncology.
“Persistent smoking among patients diagnosed with cancer is associated with adverse clinical outcomes, yet tobacco treatment has not been well-integrated into community oncology settings,” said corresponding and lead author Elyse R. Park, PhD, MPH, Program Director of the Mass General Brigham Cancer Institute’s Smokefree Support Service, and a psychologist in the Mass General Brigham Departments of Psychiatry and Medicine. “Tobacco treatment is simply essential for quality, comprehensive cancer care, and our study shows virtual, sustained cessation treatment is an effective way to accomplish that.”
Background and Study Methods
Tobacco treatment has not yet been integrated into community oncology settings to help improve outcomes for patients diagnosed with cancer who are smokers.
Researchers conducted a randomized controlled trial to assess the benefits of virtual sustained tobacco treatment intervention in community oncology settings nationwide. The study enrolled 306 English- and Spanish-speaking patients from 37 NCI Community Oncology Research Program community sites. Patients were randomly assigned to receive either sustained telehealth counseling and medication or referral to the NCI's quitline, which was considered enhanced usual care. In the sustained telehealth counseling group, patients received up to 11 synchronous telehealth sessions of motivational counseling and up to 12 weeks of free nicotine replacement therapy.
They evaluated which intervention better assisted patients recently diagnosed with cancer to quit smoking.
Key Findings
Of the participants, 73.2% smoked within 30 minutes of waking and 45.4% had non–smoking-related cancers.
At 6 months, the rates of 7-day abstinence were 28.4% in the virtual sustained treatment group and 14.7% in the enhanced usual care group. The researchers reported no significant treatment moderators.
Within the virtual sustained treatment group, 80.8% engaged in counseling and 85.7% were dispensed free nicotine replacement therapy. Those who completed more than 8 sessions were more likely to quit than those who completed less than 5 sessions (P = .005). Patients in the virtual sustained treatment group were also almost four times more likely than those in the usual care group to report guideline-concordant smoking cessation medication use.
The incremental cost per patient who quit was $7,724.
“Our findings show that patients are willing to engage in virtual sustained tobacco treatment and that this approach can meaningfully improve quit rates in community-based oncology practice,” said co-study lead Jamie S. Ostroff, PhD, Chief, Behavioral Sciences Service at Memorial Sloan Kettering Cancer Center. “Virtual sustained counseling combined with nicotine replacement therapy offers a practical, cost-effective and scalable model of tobacco treatment delivery that can reach patients wherever they receive care.”
DISCLOSURES: For full disclosures of the study authors, visit ascopubs.org.
