Smoking Cessation Intervention in Patients With a History of Cervical Intraepithelial Neoplasia or Cervical Cancer

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In a study reported in the Journal of Clinical Oncology, Vidrine et al found that a smoking cessation intervention was not effective among patients with a history of cervical intraepithelial neoplasia or cervical cancer.

Study Details

In the trial, 194 evaluable patients who reported current smoking—defined as ≥ 100 lifetime cigarettes plus any smoking in the past 30 days—were enrolled at clinics in Oklahoma City (Stephenson Cancer Center) and online nationally between February 2017 and January 2020. Participants were randomly assigned to standard treatment (n = 96) or the MAPS (Motivation and Problem Solving) intervention (n = 98).

Standard treatment consisted of repeated referrals to a tobacco cessation quitline, self-help materials, and combination nicotine replacement therapy (patch plus lozenge); MAPS consisted of all elements of standard treatment plus up to 6 proactive telephone counseling sessions over 12 months. The primary outcome measure was self-reported 7-day point prevalence abstinence from tobacco (no tobacco within the past 7 days) at 18 months; abstinence rates at 3, 6, and 12 months were also assessed.

Key Findings

No significant benefit in abstinence for MAPS vs standard treatment was observed at 18 months (14.2% vs 12.9%, P = .79; estimated odds ratio [OR] = 1.14, 95% confidence interval [CI] = 0.44–2.93).

No significant main effect was observed for abstinence rates across the four assessments (P = .60). However, a significant condition × assessment interaction was observed (P = .015). Further investigation of this interaction using logistic regression at 3, 6, and 12 months showed that abstinence rates were greater with MAPS vs standard treatment at 12 months (26.4% vs 11.9%, P = .017; estimated OR = 2.60, 95% CI = 1.19–5.89).

The investigators concluded, “MAPS led to a greater than twofold increase in smoking abstinence among survivors of cervical intraepithelial neoplasia and cervical cancer at 12 months. At 18 months, abstinence in MAPS declined to match the control condition and the treatment effect was no longer significant.”

Jennifer I. Vidrine, PhD, of the Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was supported by grants from the National Cancer Institute. For full disclosures of the study authors, visit

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