A Smoking Cessation Intervention for Oncology Clinics in Puerto Rico - A Pilot

波多黎各肿瘤诊所的戒烟干预措施——试点

• 批准号: 8641998
• 负责人: JANICE Anita BLALOCK
• 金额: $ 15.53万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-08-16 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8641998
• 关键词: Abstinence; Behavior Therapy; Biochemical; Cancer Center; Cancer Patient; Clinic; Clinical Practice Guideline; Clinical Trials; Counseling; Data; Diagnosis; Effectiveness; Emotional; Failure; General Population; Health; Health education; Hispanics; Intervention; Left; Malignant Neoplasms; Medical Staff; Methods; Moods; National Cancer Institute; Nicotine; Nicotine Dependence; Oncology; Outcome; Patients; Pharmacotherapy; Physicians; Pilot Projects; Puerto Rico; Quality of life; Randomized; Recommendation; Recurrence; Risk; Services; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Symptoms; Time; Tobacco Dependence; Tobacco smoking; Tobacco use; Treatment Failure; University of Texas M D Anderson Cancer Center; Withholding Treatment; anticancer research; base; brief intervention; cancer care; cancer diagnosis; cancer therapy; care delivery; quitline; smoking cessation; standard of care; symposium; willingness

ABSTRACT Continued tobacco smoking following a diagnosis of cancer is associated with decreased survival time, increased risk of recurrence, second primary malignancies, increased treatment complications and treatment failure. Despite the adverse health effects of continued smoking, 50% of patients with cancer who smoked prior to diagnosis continue to do so after diagnosis. Unfortunately, tobacco use treatment is not considered a core service at most ofthe National Cancer Institute (NCI) cancer centers, leaving the majority of cancer patients who want to quit with no formal assistance. In addition, there have been few smoking cessation trials for cancer patients and many ofthe trials that have been conducted have lacked biochemical verification of abstinence. There are very few smoking cessation clinical trials that have targeted Hispanic smokers, and we are unaware of any that have targeted Hispanic smokers currently undergoing cancer treatment. A recent NCI Conference on Treating Tobacco Dependence at Cancer Centers (NCl-CTTDCC) highlighted the need for improvement in these treatments, and has called for studies that evaluate methods for integrating cessation treatment into care delivery and sustaining cessation. There is evidence that cancer patients are more nicotine dependent and have more comorbid emotional and mood symptoms than the general population of smokers, suggesting that they may need more intensive forms of treatment than what is available through standard of care approaches. Quitlines have been found to significantly increase abstinence rates compared to brief interventions. While the effectiveness of quitiines in providing cessation support to smokers in the general population is well established, the willingness of cancer patients who are currently undergoing cancer treatment to use quitlines is unknown. In line with the recommendations of the NCl-CTTDCC to evaluate strategies for integrating cessation treatment into cancer care, the current pilot study will assess the feasibility of adding a quitline counseling component to clinical practice guideline-based brief counseling provided by medical staff; and estimate the effect size of the combined brief intervention counseling and quitline (BC+) compared to the brief counseling alone (BC) on abstinence at 3 and 6 month follow-ups. To accomplish these aims, cancer patients undergoing cancer treatment who are current smokers will be randomly assigned to receive brief counseling plus smoking cessation pharmacotherapy delivered in the oncology clinic setting (BC) or the BC intervention plus 7 counseling sessions delivered by the Puerto Rico Quitline (BC+). Smoking outcomes will be assessed at 3 and 6 months post-cessation. Data from this trial will be used to support larger scale clinical trials evaluating quitline delivered smoking cessation treatments for Hispanic cancer patients.

摘要 诊断癌症后继续吸烟与生存时间缩短、复发风险增加、第二原发恶性肿瘤、治疗并发症增加和治疗失败有关。尽管持续吸烟会对健康产生不利影响，但诊断前吸烟的癌症患者中有 50% 在诊断后仍继续吸烟。不幸的是，大多数国家癌症研究所 (NCI) 癌症中心并不将烟草使用治疗视为核心服务，这使得大多数想要戒烟的癌症患者得不到正式的援助。此外，针对癌症患者的戒烟试验很少，而且许多已进行的试验缺乏戒烟的生化验证。针对西班牙裔吸烟者的戒烟临床试验很少，而且我们也不知道有任何针对目前正在接受癌症治疗的西班牙裔吸烟者的戒烟临床试验。最近举行的 NCI 癌症中心烟草依赖治疗会议 (NCl-CTTDCC) 强调了改进这些治疗的必要性，并呼吁开展研究，评估将戒烟治疗纳入护理服务和维持戒烟的方法。有证据表明，与一般吸烟者相比，癌症患者对尼古丁的依赖程度更高，并且有更多的共病情绪和情绪症状，这表明他们可能需要比标准护理方法更强化的治疗形式。研究发现，与短期干预相比，戒烟热线可显着提高戒烟率。虽然戒烟热线在为普通人群中的吸烟者提供戒烟支持方面的有效性已得到充分证实，但目前正在接受癌症治疗的癌症患者使用戒烟热线的意愿尚不清楚。根据 NCl-CTTDCC 评估将戒烟治疗纳入癌症护理策略的建议，当前的试点研究将评估在医务人员提供的基于临床实践指南的简短咨询中添加戒烟热线咨询内容的可行性；并估计在 3 个月和 6 个月的随访中，与单独的简短咨询 (BC) 相比，短期干预咨询和戒烟热线 (BC+) 相结合对戒烟的效果大小。为了实现这些目标，目前吸烟的正在接受癌症治疗的癌症患者将被随机分配接受在肿瘤诊所 (BC) 提供的简短咨询加戒烟药物治疗或 BC 干预加波多黎各戒烟热线 (BC+) 提供的 7 次咨询课程。将在戒烟后 3 个月和 6 个月评估吸烟结果。该试验的数据将用于支持更大规模的临床试验，评估戒烟热线为西班牙裔癌症患者提供的戒烟治疗。