Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Psychooncology. 2018 Feb;27(2):471-476. doi: 10.1002/pon.4483. Epub 2017 Aug 4.
Smoking cessation treatment should be an important aspect of cancer care. In this study, we evaluated whether cancer-related disease factors adversely influence smoking cessation treatment.
Smokers with cancer (within 5 years of diagnosis, any tumor site) were recruited for an ongoing trial of varenicline for smoking cessation. Disease factors, assessed at baseline, included tumor site, cancer treatment, time since diagnosis, and health-related quality of life. Medication adherence was defined by 132 of 165 pills taken and counseling adherence was defined by 4 of 4 behavioral counseling sessions attended. Abstinence was bioverified at Week 12. Using logistic regression analysis, we assessed the relationship between disease factors and 12-week medication adherence, counseling adherence, and abstinence.
Of 144 participants, 56% were medication adherent, 74% were counseling adherent, and 39% were abstinent. Health-related quality of life predicted medication adherence (OR: 1.08, 95% CI, 1.01-1.16, P = .019, d = 0.20) but not counseling adherence or 12-week abstinence. Tumor site, cancer treatment, and time since diagnosis did not predict any smoking cessation treatment outcomes.
Cancer-related disease factors did not predict cancer survivors' engagement or success in smoking cessation treatment. Findings support National Comprehensive Cancer Network Clinical Practice guidelines that recommend smoking cessation treatment for all smokers with cancer, regardless of time since diagnosis.
戒烟治疗应成为癌症治疗的重要组成部分。本研究旨在评估癌症相关疾病因素是否会对戒烟治疗产生不利影响。
招募了患有癌症（诊断后 5 年内，任何肿瘤部位）的吸烟者，参加一项用伐尼克兰治疗戒烟的持续试验。在基线时评估疾病因素，包括肿瘤部位、癌症治疗、诊断后时间和健康相关生活质量。药物依从性定义为服用 165 片药物中的 132 片，咨询依从性定义为参加 4 次行为咨询中的 4 次。在第 12 周通过生物验证来确定是否戒烟。采用逻辑回归分析评估疾病因素与 12 周药物依从性、咨询依从性和戒烟之间的关系。
在 144 名参与者中，56%的患者药物依从性良好，74%的患者咨询依从性良好，39%的患者成功戒烟。健康相关生活质量预测药物依从性（比值比：1.08，95%置信区间：1.01-1.16，P=0.019，d=0.20），但不能预测咨询依从性或 12 周的戒烟率。肿瘤部位、癌症治疗和诊断后时间均不能预测任何戒烟治疗结局。
癌症相关疾病因素并不能预测癌症幸存者参与或成功戒烟治疗的情况。研究结果支持国家综合癌症网络临床实践指南的建议，即建议所有患有癌症的吸烟者（无论诊断后时间长短）都应进行戒烟治疗。
