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Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer
- Source :
- JAMA
- Publication Year :
- 2020
- Publisher :
- American Medical Association (AMA), 2020.
-
Abstract
- IMPORTANCE: Persistent smoking may cause adverse outcomes among patients with cancer. Many cancer centers have not fully implemented evidence-based tobacco treatment into routine care. 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 (n = 153) and the standard treatment (n = 150) 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% (n = 51 in the intensive treatment group) vs 21.5% (n = 29 in the standard treatment group) (difference, 13.0% [95% CI, 3.0%-23.3%]; odds ratio, 1.92 [95% CI, 1.13-3.27]; P
- Subjects :
- Counseling
Male
Temperance
medicine.medical_treatment
Health Behavior
Motivational interviewing
01 natural sciences
law.invention
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
law
Neoplasms
030212 general & internal medicine
Cotinine
Varenicline
Original Investigation
media_common
Smoking Cessation Agents
Standard treatment
Smoking
General Medicine
Middle Aged
Tobacco Use Cessation Devices
Patient Satisfaction
Female
medicine.medical_specialty
media_common.quotation_subject
Motivational Interviewing
Decision Support Techniques
03 medical and health sciences
Telephone counseling
Internal medicine
medicine
Humans
0101 mathematics
Saliva
Bupropion
Aged
business.industry
Patient Selection
010102 general mathematics
Abstinence
Nicotine replacement therapy
Telephone
chemistry
Smoking cessation
Smoking Cessation
business
Subjects
Details
- ISSN :
- 00987484
- Volume :
- 324
- Database :
- OpenAIRE
- Journal :
- JAMA
- Accession number :
- edsair.doi.dedup.....39c366c6f43147226a09eaad07bc45f4