Helping cancer patients quit smoking using brief risk communication and motivational counseling: A randomized controlled trial

Abstract

Introduction and Project Objectives: Smoking cessation after cancer diagnosis can lower the risk of disease advancement, minimize adverse treatment-related effects and improve the prognosis and quality of life of patients. We examined the effectiveness of a smoking cessation intervention using a risk communication approach with motivational counseling. Methods: This was a randomized controlled trial, in which 528 smoking cancer patients (average age 58.9 years, 455 male) were allocated either into an intervention group (n=268) or a control group (n= 260). About 72.9% of the subjects were pre-contemplating quitting. Subjects' mean daily tobacco consumption was 12.5 cigarettes, they had been smoking for over 42 years on average, and were moderately nicotine dependent. The intervention group received 15-30 min individual risk communication and counseling by a nurse counselor while the control group received standard care. Smoking status in both groups was checked at follow-ups at 1 week and at 1, 3, 6, 9, and 12 months. Results: The primary outcome was self-reported point-prevalence 7-day abstinence at 6 months. No significant differences were found between the intervention and control groups (15.7% vs 16.5%; OR 0.94, 95% CI 0.59-1.50). The secondary outcome, the rate of at least 50% self-reported reduction of smoking at 6 months, was higher in the intervention group than in the control group (16.8% vs 12.3%; OR 1.43, 95% CI 0.88-2.35). The biochemically validated quit rate at the 6-month follow-up was higher in the intervention group than in the control group (5.2% vs 3.8%; OR 1.38, 95% CI 0.60-3.16). Conclusions: The risk communication intervention was not effective for quitting but improved the rate of smoking reduction among smoking cancer patients. Project Number: 09100991