Comprehensive tobacco treatment can help cancer patients quit and abstain from smoking, according to a study from MD Anderson Cancer Center.
The prospective study analyzed 3,245 smokers treated in MD Anderson’s Tobacco Treatment Program between 2006 and 2015. At three, six and nine-month follow-ups, smoking abstinence rates averaged 45%, 46% and 44%, respectively.
The study, described as the largest smoking cessation study of cancer patients to date, was published in JAMA Network Open Sept. 27.
Based on these findings, the authors advocate for full integration of comprehensive tobacco treatment into the oncological setting.
While the study was not designed as a randomized clinical trial and did not compare different types of smoking cessation programs, past studies have shown quitlines or other minimal interventions have abstinence rates of 20% or less. As with quitlines, abstinence rates for the Tobacco Treatment Program were self-reported and were not regularly biochemically verified.
“Patients deserve the absolute best opportunity we can give them to quit smoking,” lead author, Behavioral Science Chair and Director of the Tobacco Treatment Program Paul Cinciripini, said in a statement. “Based on our data, we recommend offering comprehensive smoking cessation to cancer patients as a clinical standard of care.”
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 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.
“We tailor nicotine replacement therapy recommendations to each individual and provide support through behavioral counseling sessions over eight to 12 weeks following their initial consultation,” Professor of Behavioral Science and Medical Director of the Tobacco Treatment Program, Maher Karam-Hage, said in a statement. “Through this combined approach, we’ve seen effective results in cessation and abstinence.”
Cinciripini and Karam-Hage received grant support and medication (Chantix) from Pfizer to conduct smoking cessation trials, and have participated in two multisite trials sponsored by Pfizer.
Average cost per quit ranges from $1,900 to $2,500 at MD Anderson. 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 note this funding arrangement is progressive and could serve as a model for other states.
The MD Anderson program is open to employees as well. The study did not find a difference in abstinence rates between cancer patients and non-patients. For cancer patients, smoking also negatively impacts survival and treatment.
“Quitting at time of diagnosis increases the chance of survival by 30% to 40%. Patients also have less chance of a recurrence or secondary cancer if they quit. They will have fewer side effects and their treatments will be more effective. Longer term, they will enjoy a better quality of life,” said Assistant Professor of Behavioral Science Diane Beneventi.
This study received funding support from the State of Texas Tobacco Settlement funds and from MD Anderson’s Cancer Center Support Grant (CA016672).
