Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.
Department of Oncologic Sciences, University of South Florida, Tampa, Florida.
Cancer. 2020 Dec 1;126(23):5165-5172. doi: 10.1002/cncr.33162. Epub 2020 Sep 9.
Abstaining from smoking after a cancer diagnosis is critical to mitigating the risk of multiple adverse health outcomes. Although many patients with cancer attempt to quit smoking, the majority relapse. The current randomized controlled trial evaluated the efficacy of adapting an evidence-based smoking relapse prevention (SRP) intervention for patients with cancer.
The trial enrolled 412 patients newly diagnosed with cancer who had recently quit smoking. Participants were randomized to usual care (UC) or SRP. Participants in the UC group received the institution's standard of care for treating tobacco use. Participants in the SRP group in addition received a targeted educational DVD plus a validated self-help intervention for preventing smoking relapse. The primary outcome was smoking abstinence at 2 months, 6 months, and 12 months.
Abstinence rates for participants in the SRP and UC groups were 75% versus 71% at 2 months and 69% versus 64% at 6 months (Ps > .20). At 12 months, abstinence rates among survivors were 68% for those in the SRP group and 63% for those in the UC group (P = .38). Post hoc analyses revealed that across 2 months and 6 months, patients who were married/partnered were more likely to be abstinent after SRP than UC (P = .03).
A smoking relapse prevention intervention did not reduce relapse rates overall, but did appear to have benefited those participants who had the social support of a partner. Future work is needed to extend this effect to the larger population of patients.
癌症诊断后戒烟对于减轻多种不良健康后果的风险至关重要。尽管许多癌症患者试图戒烟,但大多数人会复吸。目前这项随机对照试验评估了为癌症患者改编基于证据的戒烟复发预防(SRP)干预措施的效果。
该试验纳入了 412 名新诊断为癌症且近期戒烟的患者。参与者被随机分配到常规护理(UC)或 SRP 组。UC 组的参与者接受该机构治疗烟草使用的标准护理。SRP 组的参与者除了接受有针对性的教育 DVD 外,还接受了一种经过验证的预防吸烟复发的自助干预措施。主要结局是在 2 个月、6 个月和 12 个月时的吸烟戒断率。
SRP 组和 UC 组的参与者在 2 个月时的戒烟率分别为 75%和 71%,在 6 个月时的戒烟率分别为 69%和 64%(P>.20)。在 12 个月时,SRP 组幸存者的戒烟率为 68%,UC 组幸存者的戒烟率为 63%(P=.38)。事后分析显示,在 2 个月和 6 个月时,已婚/有伴侣的患者在接受 SRP 后比接受 UC 更有可能戒烟(P=.03)。
戒烟复发预防干预措施并未降低总体复发率,但似乎使那些有伴侣支持的参与者受益。未来需要开展更多工作,将这种效果扩展到更大的患者群体。