Robert C Klesges1, Rebecca A Krukowski2, James L Klosky3, Wei Liu4, Deo Kumar Srivastava4, James M Boyett4, Jennifer Q Lanctot5, Melissa M Hudson6, Charla Folsom5, Harry Lando7, Leslie L Robison5. 1. Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA; The Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address: rklesges@uthsc.edu. 2. The Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. 3. Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA. 4. Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA. 5. Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA. 6. Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA. 7. Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA.
Abstract
OBJECTIVE: The purpose of the study (conducted 2010-2013) was to determine the efficacy of two common types of tobacco quitlines in adult cancer survivors who regularly smoked cigarettes. METHOD: Adult onset cancer survivors in Memphis, Tennessee (n=427, 67% female, 60% Caucasian) were randomized either to a Proactive (i.e., counselor-initiated calls) or Reactive (i.e., participant-initiated calls) quitline. Both conditions also received nicotine replacement therapy. The primary outcome was biochemically-verified (i.e., salivary cotinine) smoking cessation. RESULTS: While 12-month self-reported abstinence was consistent with other published studies of smoking cessation (22% and 26% point prevalence abstinence for Proactive and Reactive conditions, respectively), 48% of participants who were tested for cotinine failed biochemical verification, indicating a considerable falsification of self-reported cessation. Adjusted cessation rates were less than 5% in both intervention conditions. CONCLUSION: Our results are consistent with other studies indicating that traditional smoking cessation interventions are ineffective among cancer survivors. Moreover, self-reports of cessation were unreliable in cancer survivors participating in aquitline intervention, indicating that future studies should include biochemical verification. Given the importance of smoking cessation among cancer survivors and low cessation rates in the current study, it may be necessary to design alternative interventions for this population. ClinicalTrials.gov identifier: NCT00827866.
RCT Entities:
OBJECTIVE: The purpose of the study (conducted 2010-2013) was to determine the efficacy of two common types of tobacco quitlines in adult cancer survivors who regularly smoked cigarettes. METHOD: Adult onset cancer survivors in Memphis, Tennessee (n=427, 67% female, 60% Caucasian) were randomized either to a Proactive (i.e., counselor-initiated calls) or Reactive (i.e., participant-initiated calls) quitline. Both conditions also received nicotine replacement therapy. The primary outcome was biochemically-verified (i.e., salivary cotinine) smoking cessation. RESULTS: While 12-month self-reported abstinence was consistent with other published studies of smoking cessation (22% and 26% point prevalence abstinence for Proactive and Reactive conditions, respectively), 48% of participants who were tested for cotinine failed biochemical verification, indicating a considerable falsification of self-reported cessation. Adjusted cessation rates were less than 5% in both intervention conditions. CONCLUSION: Our results are consistent with other studies indicating that traditional smoking cessation interventions are ineffective among cancer survivors. Moreover, self-reports of cessation were unreliable in cancer survivors participating in a quitline intervention, indicating that future studies should include biochemical verification. Given the importance of smoking cessation among cancer survivors and low cessation rates in the current study, it may be necessary to design alternative interventions for this population. ClinicalTrials.gov identifier: NCT00827866.
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