Virtual Sustained Tobacco Treatment for Patients With Cancer: A Randomized Controlled Trial (ECOG-ACRIN: EAQ171CD) Within the National Cancer Institute Community Oncology Research Program
Abstract
PURPOSE Persistent smoking among patients diagnosed with cancer is associated with adverse clinical outcomes, yet tobacco treatment has not been integrated into community oncology settings. We conducted a trial of a virtual sustained tobacco treatment intervention across community oncology settings nationwide. METHODS This randomized controlled trial compared the effectiveness of sustained telehealth counseling plus medication (virtual sustained treatment [VST]) to referral to the National Cancer Institute (NCI) quitline (enhanced usual care [EUC]) in assisting patients recently diagnosed with cancer to quit smoking. The VST group received up to 11 synchronous telehealth sessions (four weekly, four biweekly, three monthly) of motivational counseling and up to 12 weeks of free nicotine replacement therapy (NRT). RESULTS From August 2019 to December 2022, 306 English- and Spanish-speaking patients were randomly assigned from 37 NCI Community Oncology Research Program community sites. Participants were 70.9% female; 86.3% was White; the median age was 57 years; and 45.4% had non–smoking-related tumors. A total of 221 of 302 (73.2%) smoked within 30 minutes of waking. Six-month, 7-day point abstinence rates were 28.4% (42 of 148) in the VST group versus 14.7% (21 of 143) in the EUC group; there were no significant treatment moderators. A total of 80.8% (126 of 156) of VST participants engaged in counseling, and 85.7% (108 of 126) were dispensed NRT. Participants who completed >8 sessions versus <5 sessions were more likely to quit; P = .005. VST participants were almost four times more likely to report guideline-concordant smoking cessation medication use. Continuous abstinence and significant reduction rates at 6 months were higher in the VST group. The incremental cost per quit was $7,724 in US dollars. CONCLUSION Among recently diagnosed patients, sustained remotely delivered telehealth counseling and free NRT were well utilized and nearly doubled 6-month quit rates compared with EUC. Findings support the benefit of adopting sustained tobacco treatment within community oncology care settings nationwide.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (30)
Elyse R. Park
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
JoRean D. Sicks
Center for Biostatistics and Health Data Science, Brown University—ECOG-ACRIN Biostatistics Center, Providence, RI
Brett M. Goshe
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Ilana F. Gareen
Department of Epidemiology, Brown University School of Public Health, Providence, RI
Benjamin A. Herman
Center for Biostatistics and Health Data Science, Brown University—ECOG-ACRIN Biostatistics Center, Providence, RI
Alexander Taurone
Center for Biostatistics and Health Data Science, Brown University—ECOG-ACRIN Biostatistics Center, Providence, RI
Seth Bittig
Center for Biostatistics and Health Data Science, Brown University—ECOG-ACRIN Biostatistics Center, Providence, RI
Angela Wangari Walter
Health Promotion and Resiliency Intervention Research Center, Massachusetts General Hospital, Boston, MA
Susan Regan
Rachel Rosen
Natalie Durieux
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Autumn W. Rasmussen
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Douglas E. Levy
The Mongan Institute, Massachusetts General Hospital, Boston, MA
Gabriella Nicolosi
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Alona Muzikansky
Michael A. Thompson
Aurora Health Care, Milwaukee, WI
Michelle Lui
Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Laura Malloy
Health Promotion and Resiliency Intervention Research Center, Massachusetts General Hospital, Boston, MA
Irina Gonzalez
Health Promotion and Resiliency Intervention Research Center, Massachusetts General Hospital, Boston, MA
Lucy Finkelstein-Fox
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Nathan D. Munson
ThedaCare Regional Cancer Center, Appleton, WI
Molly M. Greenwade
CoxHealth South Hospital, Springfield, MO
David M. King
Metro Minnesota Community Oncology Res Consortium, Fridley, MN
Bharat Jenigiri
Physicians' Clinic of Iowa PC, Cedar Rapids, IA
Brian L. Burnette
Saint Vincent Hospital Cancer Center, Green Bay, WI
Alyssa D. Throckmorton
Baptist Memorial Hospital and Cancer Center, Memphis, TN
Martha S. Tingen
Augusta University Medical Center, Augusta, GA
Ruth C. Carlos
Department of Radiology, Columbia University, New York, NY
Lynne I. Wagner
University of North Carolina Chapel Hill, Chapel Hill, NC
Jamie S. Ostroff
Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY