Rates of Smoking Cessation at 6 and 12 Months after a Clinical Tobacco Smoking Cessation Intervention in Head and Neck Cancer Patients in Northern Ontario, Canada.

Stacey A Santi,Michael S C Conlon,Margaret L Meigs,Deborah P Saunders,Stacey M Davidson,Kyle Mispel-Beyer

doi:10.3390/curroncol29030130

Abstract

Smoking during cancer treatment is associated with reduced treatment response and cancer recurrence in patients with tobacco-related cancers. The purpose of this study was to examine smoking characteristics in head and neck cancer patients (n = 503) with a history of smoking and examine the impact of an intensive clinical tobacco intervention to patients who were currently smoking. All participants completed an interviewer-administered questionnaire at study enrollment which examined smoking behaviours, motivations to quit, and strategies used to cessate smoking. Follow-up assessments were completed at 6- and 12-months which monitored whether patients had quit smoking, remained cessated, or continued to smoke since study recruitment. For those who were currently smoking (n = 186, 37.0%), an intensive clinical tobacco intervention that utilized the 3A’s—Ask, Advise, Arrange—and the Opt-Out approach was offered to assist with smoking cessation at their new patient visit and followed-up weekly during their head and neck radiation therapy for 7 weeks. At 6 months, 23.7% (n = 41) of those who were smoking successfully quit; 51.2% quit ‘cold turkey’ (defined as using no smoking cessation assistance, aids or pharmacotherapy to quit), while 34.9% used pharmacotherapy (varenicline (Champix)) to quit. On average, it took those who were smoking 1–5 attempts to quit, but once they quit they remained cessated for the duration of the study. Although the head and neck cancer patients in this study reported high levels of nicotine dependence, many were able to successfully cessate.

Highlights

Continued smoking in patients who have been diagnosed and receive treatment for head and neck cancer is associated with decreased survival, higher rates of primary tumours [1], less successful treatment outcomes, and complications during cancer treatment [2,3]
The program utilized the 3A’s—Ask, Advise, Arrange—and the Opt-Out [6] approach to assist with smoking cessation, and patients were provided with motivational interviewing, and access to pharmacotherapy, nicotine replacement therapy, or combination therapy
The purpose of this study was to examine the smoking characteristics of patients with head and neck cancer who had a history of smoking, and assess the smoking cessation rates in those who were currently smoking after receiving an intensive clinical tobacco intervention that utilized the 3A’s—Ask, Advise, Arrange—and the ‘Opt-Out’

Summary

Introduction

Continued smoking in patients who have been diagnosed and receive treatment for head and neck cancer is associated with decreased survival, higher rates of primary tumours [1], less successful treatment outcomes, and complications during cancer treatment [2,3]. The purpose of the present study was to characterize the smoking behaviours and examine the impact of an intensive clinical tobacco intervention in a population of head and neck cancer patients who were being treated at the Northeast Cancer Centre (NECC). This geographical region is characterized by a large rural population, and has some of the highest reported smoking rates, as well as some of the highest lung cancer rates (another tobacco-related cancer) relative to the entire province of Ontario [5]. The findings reported outline the study outcomes, cessation rates, smoking characteristics, as well as relapse rates, at 6 and 12 months after the implementation of a clinical tobacco smoking cessation intervention program

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Conclusion