A new study shows that a smoking cessation treatment programme delivered at community oncology care settings can nearly double quit rates for cancer patients who currently smoke.

Investigators from Mass General Brigham Cancer Institute and Memorial Sloan Kettering Cancer Centre led a randomised clinical trial for the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN), testing a treatment programme that includes virtual therapy and nicotine replacement medications.

Results, published in the Journal of Clinical Oncology, show that the intervention was well utilised and nearly doubled the quit rate at 6 months’ post-treatment.

English- and Spanish-speaking participants received standard-of-care treatment for their cancer as directed by their oncologist, plus either referral to the National Cancer Institute (NCI) Quitline—a free counselling service accessible by phone—or up to 11 telehealth sessions with tobacco cessation counsellors and free nicotine replacement therapy (NRT) in the form of lozenges and skin patches.

The study found that the more sessions participants completed, the higher their likelihood of quitting.

The programme was both cost-effective and satisfying for patients, supporting its potential nationwide implementation.

“Persistent smoking among patients diagnosed with cancer is associated with adverse clinical outcomes, yet tobacco treatment has not been well-integrated into community oncology settings,” said corresponding and lead author Elyse R.Park, PhD, MPH, Programme Director of the Mass General Brigham Cancer Institute’s Smokefree Support Service, and a psychologist in the Mass General Brigham Departments of Psychiatry and Medicine.

Park co-led the clinical trial for ECOG-ACRIN with Jamie S.Ostroff, Chief, Behavioural Sciences Service at Memorial Sloan-Kettering Cancer Centre.

“Tobacco treatment is simply essential for quality, comprehensive cancer care, and our study shows virtual, sustained cessation treatment is an effective way to accomplish that.”

Around 15% of newly diagnosed cancer patients smoke, and many continue after diagnosis.

For the roughly 80% of patients who receive their cancer care at community sites (rather than at academic hospitals), a validated, effective smoking cessation programme does not yet exist.

The findings from this study support the benefit of adopting sustained tobacco treatment within community-based oncology care settings nationwide.

Virtual, sustained cessation treatment, delivered along with the medications patients receive to treat their cancer, has had recent successes in academic hospital settings, as lead authors Park and Ostroff had previously reported in JAMA in 2020.

ECOG-ACRIN designed the Smoke-Free Support Study 2.0 (EAQ171CD, NCT03808818) to determine if patients in community-based settings could get those same benefits.

The study enrolled 306 participants who were recently diagnosed with cancer, from 37 community care sites around the country.

All sites were part of the NCI Community Oncology Research Programme (NCORP).

Participants were enrolled from August 2019 through December 2022 and randomised into two groups.

The intervention group—which received standard care along with sustained telehealth counselling plus NRT patches and lozenges—was nearly four times as likely to use safe and effective smoking cessation medications and reported nearly double the six-month quit rate of the enhanced usual care group.

“Our findings show that patients are willing to engage in virtual sustained tobacco treatment and that this approach can meaningfully improve quit rates in community-based oncology practice,” said Ostroff.

“Virtual sustained counselling combined with nicotine replacement therapy offers a practical, cost-effective and scalable model of tobacco treatment delivery that can reach patients wherever they receive care.”

Source: Mass General Brigham