Brief physician-initiated quit-smoking strategies for clinical oncology settings: A trial coordinated by the Eastern Cooperative Oncology Group
Brief physician-initiated quit-smoking strategies for clinical oncology settings: A trial coordinated by the Eastern Cooperative Oncology Group
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DOI：
10.1200/jco.2003.04.122
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发表时间：
2003-01-15
影响因子：
45.3
通讯作者：
Engstrom, PF
中科院分区：
文献类型：
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作者：
Schnoll, RA;Zhang, B;Engstrom, PF
目的：虽然癌症患者使用烟草会增加复发的风险，降低治疗效果，并使生活质量恶化，但在诊断前吸烟的患者中约有三分之一继续吸烟。由于患者经常与肿瘤学家接触，因此评估了以医生为基础的戒烟治疗的效果。方法：癌症患者（n = 432）被随机分配到常规治疗组或美国国立卫生研究院（NIH）医师吸烟干预组。主要结局是研究开始后6个月和12个月的7天点流行禁欲。结果：随访6个月时，常规护理组（11.9%）与干预组（14.4%）的戒烟率差异无统计学意义；随访12个月时，常规护理组（13.6%）与干预组（13.3%）的戒烟率差异无统计学意义。如果患者患有头颈癌或肺癌，16岁以后开始吸烟，在过去6个月内使用戒烟自助指南或治疗的基线报告，并且显示出更大的戒烟意愿，则更有可能在6个月内戒烟。如果患者每天抽15支或更少的烟，患有头颈癌或肺癌，尝试过集体戒烟计划，并且表现出更大的戒烟欲望，那么他们更有可能在12个月时戒烟。最后，与常规护理组相比，在干预组中，医生对NIH医生吸烟治疗模型的依从性更高。结论：虽然培训医生为癌症患者提供戒烟治疗可以提高医生对临床实践指南的依从性，但医生戒烟干预措施未能在癌症患者的长期戒烟率方面产生显着收益。(C) 2003年由美国临床肿瘤学会出版。
Purpose : Although tobacco use by cancer patients increases the risk of relapse, diminishes treatment efficacy, and worsens quality of life, about one third of patients who smoked before their diagnosis continue to smoke. Because patients have regular contact with oncologists, the efficacy of a physician-based smoking cessation treatment was evaluated.Methods: Cancer patients (n = 432) were randomly assigned to either usual care or a National Institutes of Health (NIH) physician-based smoking intervention. The primary outcome was 7-day point prevalence abstinence at 6 and 12 months after study entry.Results: At the 6-month follow-up, there was no significant difference in quit rates between the usual care (11.9%) and intervention (14.4%) groups, and there was no significant difference between the usual care (13.6%) and intervention (13.3%) groups at the 12-month follow-up. Patients were more likely to have quit smoking at 6 months if they had head and neck or lung cancer, began smoking after the age of 16, reported at baseline using a cessation self-help guide or treatment in the last 6 months, and showed greater baseline desire to quit. Patients were more likely to have quit smoking at 12 months if they smoked 15 or fewer cigarettes per day, had head and neck or lung cancer, tried a group cessation program, and showed greater baseline desire to quit. Finally, there was greater adherence among physicians to the NIH model for physician smoking treatment for patients in the intervention versus the usual care group.Conclusion: While training physicians to provide smoking cessation treatment to cancer patients can enhance physician adherence to clinical practice guidelines, physician smoking cessation interventions fail to yield significant gains in long-term quit rates among cancer patients. (C) 2003 by American Society of Clinical Oncology.