Helping cancer patients quit smoking using brief advice based on risk communication: A randomized controlled trial

William H C Li,Katherine K W Lam,Sophia S C Chan,K Y Ho,Derek Y T Cheung,M P Wang,T H Lam,Yannes T Y Cheung

doi:10.1038/s41598-018-21207-1

William H C Li, Katherine K W Lam + Show 6 more

Open Access

https://doi.org/10.1038/s41598-018-21207-1

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Journal: Scientific Reports	Publication Date: Feb 9, 2018
Citations: 19	License type: open-access

Affiliation: University of Hong Kong

Abstract

This randomized controlled trial aimed to examine the effectiveness of a smoking cessation intervention using a risk communication approach. A total of 528 smoking cancer patients were randomly allocated either into an intervention group (n = 268) to receive brief advice based on risk communication by a nurse counselor or a control group (n = 260) to receive standard care. Subjects in both groups received a smoking cessation booklet. Patient follow-ups were at 1 week and at 1, 3, 6, 9 and 12 months. No significant differences were found in self-reported point-prevalence 7-day abstinence between the intervention and control groups at 6 months (15.7% vs 16.5%; OR 0.94, 95% CI 0.59–1.50). The rate of at least 50% self-reported reduction of smoking at 6 months, was higher in the intervention group than in the control group (16.8% vs 12.3%; OR 1.43, 95% CI 0.88–2.35). The biochemically validated quit rate at the 6-month follow-up was higher in the intervention group than in the control group (5.2% vs 3.8%; OR 1.38, 95% CI 0.60–3.16). These data suggest that advice based on risk communication was not effective for quitting but improved the rate of smoking reduction among smoking cancer patients.

Highlights

Tobacco smoking causes many types of cancer, including cancer of the lung, larynx, oesophagus, stomach, liver, pancreas, kidney, ureter, bladder and colo-rectum, as well as acute myeloid leukaemia[1]
Wakefield et al applied behavioural intervention in an randomized controlled trials (RCTs) to help patients with mixed cancer sites and demonstrated enhanced smoking cessation (29% vs. 18%; n = 137, p = 0.32)[22]. These RCTs were limited by small sample size and no RCTs have been conducted on Chinese cancer patients who smoke in Hong Kong and elsewhere
The Consolidation of Standards for Reporting Trials (CONSORT) flowchart in Fig. 1 indicated the process of the study and no adverse effects were reported throughout the trial

Summary

Introduction

Tobacco smoking causes many types of cancer, including cancer of the lung, larynx, oesophagus, stomach, liver, pancreas, kidney, ureter, bladder and colo-rectum, as well as acute myeloid leukaemia[1]. Our intervention aimed to change the patients’ attitudes and their subjective norms through risk communication, which was used in a previous study, showing a 24% self-reported quit rate at 6 months in lung cancer patients[18]. Behavioural intervention has been shown to be helpful in improving cessation rates in smoking cancer patients in several randomized controlled trials (RCTs). Wakefield et al applied behavioural intervention in an RCT to help patients with mixed cancer sites and demonstrated enhanced smoking cessation (29% vs 18%; n = 137, p = 0.32)[22]. The present RCT with a large sample size aimed to study the effectiveness of a face-to-face individualized brief risk communication to encourage patients with cancer to stop smoking. We hypothesized that participants in the intervention group would (i) have a higher smoking cessation rates by self-reporting and biochemical validation and (ii) have a higher self-reported rate of having reduced daily cigarette consumption by at least 50%

Methods

Results

Conclusion