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Smoking Cessation Treatment and Outcomes in Medium to Heavy Cigarette Smokers being Treated for Cancer in Jordan

  • Hawari, Feras Ibrahim (Cancer Control Office, King Hussein Cancer Center) ;
  • Obeidat, Nour Ali (Cancer Control Office, King Hussein Cancer Center) ;
  • Ayub, Hiba Salem (Cancer Control Office, King Hussein Cancer Center) ;
  • Dawahrah, Sahar Sattam (Cancer Control Office, King Hussein Cancer Center) ;
  • Hawari, Saif Feras (Medical student, Royal College of Surgeons in Ireland)
  • Published : 2013.11.30

Abstract

Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

Keywords

Smoking cessation;cancer patients;abstinence rates;failure to quit

References

  1. Barrera R, Shi W, Amar D, et al (2005). Smoking and timing of cessation: impact on pulmonary complications after thoracotomy. Chest, 127, 1977-83. https://doi.org/10.1378/chest.127.6.1977
  2. Baser S, Shannon VR, Eapen GA, et al (2006). Smoking cessation after diagnosis of lung cancer is associated with a beneficial effect on performance status. Chest, 130, 1784-90. https://doi.org/10.1016/S0012-3692(15)50902-1
  3. Belbeisi A, Al-Nsour M, Batieha A, Brown DW, Walke HT (2009). A surveillance summary of smoking and review of tobacco control in Jordan. Globalization and Health, 5, 5-18. https://doi.org/10.1186/1744-8603-5-5
  4. Blalock JA, Lam C, Minnix JA, et al (2011). The effect of mood, anxiety, and alcohol use disorders on smoking cessation in cancer patients. J Cogn Psychother, 25, 82-96. https://doi.org/10.1891/0889-8391.25.1.82
  5. Cahill K, Stead LF, Lancaster T (2012). Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev, 4, 6103.
  6. Daniel M, Keefe FJ, Lyna P, et al (2009). Persistent smoking after a diagnosis of lung cancer is associated with higher reported pain levels. J Pain, 10, 323-8. https://doi.org/10.1016/j.jpain.2008.10.006
  7. De Jong FA, Sparreboom A, Verweij J, Mathijssen RH (2008). Lifestyle habits as a contributor to anti-cancer treatment failure. Eur J Cancer, 44, 374-82. https://doi.org/10.1016/j.ejca.2007.12.012
  8. Ditre JW, Gonzalez BD, Simmons VN, et al (2011). Associations between pain and current smoking status among cancer patients. Pain, 152, 60-5. https://doi.org/10.1016/j.pain.2010.09.001
  9. Do KA, Johnson MM, Doherty DA, et al (2003). Second primary tumors in patients with upper aerodigestive tract cancers: joint effects of smoking and alcohol (United States). Cancer Causes Control, 14, 131-8. https://doi.org/10.1023/A:1023060315781
  10. Dresler CM (2003). Is it more important to quit smoking than which chemotherapy is used? Lung Cancer, 39, 119-24. https://doi.org/10.1016/S0169-5002(02)00455-5
  11. Ebbert JO, Burke MV, Hays JT, Hurt RD (2009). Combination treatment with varenicline and nicotine replacement therapy. Nicotine Tob Res, 11, 572-6. https://doi.org/10.1093/ntr/ntp042
  12. Ehlers SL, Gastineau DA, Patten CA, et al (2011). The impact of smoking on outcomes among patients undergoing hematopoietic SCT for the treatment of acute leukemia. Bone Marrow Transplant, 46, 285-90. https://doi.org/10.1038/bmt.2010.113
  13. Fiore MC, Goplerud E, Schroeder SA (2012). The joint commission's new tobacco-cessation measures--will hospitals do the right thing? N Engl J Med, 366, 1172-4. https://doi.org/10.1056/NEJMp1115176
  14. Fiore MC, Jaen CR, Baker TB, et al (2008). Update clinical practice guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service. May 2008.
  15. Fox JL, Rosenzweig KE, Ostroff JS (2004). The effect of smoking status on survival following radiation therapy for non-small cell lung cancer. Lung Cancer, 44, 287-93. https://doi.org/10.1016/j.lungcan.2003.11.012
  16. Garces YI, Schroeder DR, Nirelli LM, et al (2007). Second primary tumors following tobacco dependence treatments among head and neck cancer patients. Am J Clin Oncol, 30, 531-9. https://doi.org/10.1097/COC.0b013e318059adfc
  17. Garces YI, Yang P, Parkinson J, et al (2004). The relationship between cigarette smoking and quality of life after lung cancer diagnosis. Chest, 126, 1733-41. https://doi.org/10.1378/chest.126.6.1733
  18. Gilpin EA, White MM, Farkas AJ, Pierce JP (1999). Home smoking restrictions: which smokers have them and how they are associated with smoking behavior. Nicotine Tob Res, 1, 153-62.
  19. Goldstein AO, Ripley-Moffitt CE, Pathman DE, Patsakham KM (2012). Tobacco use treatment at the U.S. National Cancer Institute’s designated Cancer Centers. Nicotine Tob Res, 15, 52-8.
  20. Gritz ER, Carr CR, Rapkin D, et al (1993). Predictors of long-term smoking cessation in head and neck cancer patients. Cancer Epidemiol Biomarkers Prev, 2, 261-70.
  21. Gritz ER, Fingeret MC, Vidrine DJ (2006). Successes and failures of the teachable moment - smoking cessation in cancer patients. Cancer, 106, 17-27. https://doi.org/10.1002/cncr.21598
  22. Gritz ER, Schacherer C, Koehly L, Nielsen IR, Abemayor E (1999). Smoking withdrawal and relapse in head and neck cancer patients. Head Neck, 21, 420-7. https://doi.org/10.1002/(SICI)1097-0347(199908)21:5<420::AID-HED7>3.0.CO;2-U
  23. Hajek P, Stead LF, West R, et al (2009). Relapse prevention interventions for smoking cessation. Cochrane Database Syst Rev, 2013, 3999.
  24. Hawari F, Obeidat N, Beano H, et al (2012). Smoking abstinence rates and reasons for failure to quit smoking in cancer patients in Jordan. Respiration, 83, 233-8. https://doi.org/10.1159/000328759
  25. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO (1991). The fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. Br J Addict, 86, 1119-27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
  26. Hughes JR, Stead LF, Lancaster T (2007). Antidepressants for smoking cessation. Cochrane Database Syst Rev, 1, 31.
  27. Joshu CE, Mondul AM, Meinhold CL, et al (2011). Cigarette smoking and prostate cancer recurrence after prostatectomy. J Natl Cancer Inst, 103, 835-8. https://doi.org/10.1093/jnci/djr124
  28. Kaufman EL, Jacobson JS, Hershman DL, Desai M, Neugut AI (2008). Effect of breast cancer radiotherapy and cigarette smoking on risk of second primary lung cancer. J Clin Oncol, 26, 392-8. https://doi.org/10.1200/JCO.2007.13.3033
  29. Kawaguchi T, Matsumura A, Iuchi K, et al (2006). Second primary cancers in patients with stage III non-small cell lung cancer successfully treated with chemo-radiotherapy. Jpn J Clin Oncol, 36, 7-11. https://doi.org/10.1093/jjco/hyi208
  30. Kenfield SA, Stampfer MJ, Chan JM, Giovannucci E (2011). Smoking and prostate cancer survival and recurrence. JAMA, 305, 2548-55. https://doi.org/10.1001/jama.2011.879
  31. Li CI, Daling JR, Porter PL, Tang MT, Malone KE (2009). Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor-positive invasive breast cancer. J Clin Oncol, 27, 5312-8. https://doi.org/10.1200/JCO.2009.23.1597
  32. Liu AS, Kao HK, Reish RG, et al (2011). Postoperative complications in prosthesis-based breast reconstruction using acellular dermal matrix. Plast Reconstr Surg, 127, 1755-62. https://doi.org/10.1097/PRS.0b013e31820cf233
  33. Marks DI, Ballen K, Logan BR, et al (2009). The effect of smoking on allogeneic transplant outcomes. Biol Blood Marrow Transplant, 15, 1277-87. https://doi.org/10.1016/j.bbmt.2009.06.005
  34. Mazza R, Lina M, Boffi R, et al (2010). Taking care of smoker cancer patients: a review and some recommendations. Ann Oncol, 21, 1404-9. https://doi.org/10.1093/annonc/mdp599
  35. Mazza R, Lina M, Invernizzi G, et al (2011). The gap between tobacco treatment guidelines, health service organization, and clinical practice in comprehensive cancer centres. J Oncol, 2011, 145617.
  36. Mills AL, Messer K, Gilpin EA, Pierce JP (2009). The effect of smoke-free homes on adult smoking behavior: a review. Nicotine Tob Res, 11, 1131-41. https://doi.org/10.1093/ntr/ntp122
  37. Moller AM, Villebro N, Pedersen T, Tonnesen H (2002). Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet, 359, 114-7. https://doi.org/10.1016/S0140-6736(02)07369-5
  38. Monson JM, Stark P, Reilly JJ, et al (1998). Clinical radiation pneumonitis and radiographic changes after thoracic radiation therapy for lung carcinoma. Cancer, 82, 842-50. https://doi.org/10.1002/(SICI)1097-0142(19980301)82:5<842::AID-CNCR7>3.0.CO;2-L
  39. Nayan S, Gupta MK, Sommer DD (2011). Evaluating smoking cessation interventions and cessation rates in cancer patients: a systematic review and meta-analysis. ISRN Oncol, 2011, 849023.
  40. Nguyen SK, Masson-Cote L, Fortin A, Dagnault A (2010). Influence of smoking status on treatment outcomes after post-operative radiation therapy for non-small-cell lung cancer. Radiother Oncol, 96, 89-93. https://doi.org/10.1016/j.radonc.2010.05.008
  41. O’Sullivan JM, Huddart RA, Norman AR, et al (2003). Predicting the risk of bleomycin lung toxicity in patients with germ-cell tumours. Ann Oncol, 14, 91-6. https://doi.org/10.1093/annonc/mdg020
  42. Parsons A, Daley A, Begh R, Aveyard P (2010). Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ, 340, 5569. https://doi.org/10.1136/bmj.b5569
  43. Peppone LJ, Mustian KM, Morrow GR, et al (2011). The effect of cigarette smoking on cancer treatment-related side effects. Oncologist, 16, 1784-92. https://doi.org/10.1634/theoncologist.2011-0169
  44. Petros WP, Younis IR, Ford JN, Weed SA (2012). Effects of tobacco smoking and nicotine on cancer treatment. Pharmacotherapy, 32, 920-31. https://doi.org/10.1002/j.1875-9114.2012.01117
  45. Rigotti NA, Clair C, Munafo MR, Stead LF (2012). Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev, 5, 1837.
  46. Sanderson Cox L, Patten CA, Ebbert JO, et al (2002). Tobacco use outcomes among patients with lung cancer treated for nicotine dependence. J Clin Oncol, 20, 3461-9. https://doi.org/10.1200/JCO.2002.10.085
  47. Sardari Nia P, Weyler J, Colpaert C, et al (2005). Prognostic value of smoking status in operated non-small cell lung cancer. Lung Cancer, 47, 351-9. https://doi.org/10.1016/j.lungcan.2004.08.011
  48. Schnoll RA, James C, Malstrom M, et al (2003). Longitudinal predictors of continued tobacco use among patients diagnosed with cancer. Ann Behav Med, 25, 214-22. https://doi.org/10.1207/S15324796ABM2503_07
  49. Schnoll RA, Zhang B, Rue M, et al (2003). Brief physician-initiated quit-smoking strategies for clinical oncology settings: a trial coordinated by the Eastern cooperative oncology group. J Clin Oncol, 21, 355-65. https://doi.org/10.1200/JCO.2003.04.122
  50. Selber JC, Kurichi JE, Vega SJ, Sonnad SS, Serletti JM (2006). Risk factors and complications in free TRAM flap breast reconstruction. Ann Plast Surg, 56, 492-7. https://doi.org/10.1097/01.sap.0000210180.72721.4a
  51. Shavelle RM, Paculdo DR, Strauss DJ, Kush SJ (2008). Smoking habit and mortality: a meta-analysis. J Insur Med, 40, 170-8.
  52. Simmons VN, Litvin EB, Jacobsen PB, et al (2013). Predictors of smoking relapse in patients with thoracic cancer or head and neck cancer. Cancer, 119, 1420-7. https://doi.org/10.1002/cncr.27880
  53. Stead LF, Lancaster T (2012). Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev, 10, 8286.
  54. Stead LF, Perera R, Bullen C, et al (2012). Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev, 11, 146.
  55. Stead LF, Perera R, Mant D, Lancaster T (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev, 1, 146.
  56. Tran BT, Halperin A, Chien JW (2011). Cigarette smoking and outcomes after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant, 17, 1004-11. https://doi.org/10.1016/j.bbmt.2010.10.032
  57. Van der Bol JM, Mathijssen RH, Loos WJ, et al (2007). Cigarette smoking and irinotecan treatment: pharmacokinetic interaction and effects on neutropenia. J Clin Oncol, 25, 2719-26. https://doi.org/10.1200/JCO.2006.09.6115
  58. Videtic GM, Stitt LW, Dar AR, et al (2003). Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol, 21, 1544-9. https://doi.org/10.1200/JCO.2003.10.089
  59. Walker MS, Vidrine DJ, Gritz ER, et al (2006). Smoking relapse during the first year after treatment for early-stage non-small-cell lung cancer. Cancer Epidemiol Biomarkers Prev, 15, 2370-7. https://doi.org/10.1158/1055-9965.EPI-06-0509
  60. Waller LL, Weaver KE, Petty WJ, Miller AA (2010). Effects of continued tobacco use during treatment of lung cancer. Expert Rev Anticancer Ther, 10, 1569-75. https://doi.org/10.1586/era.10.140
  61. WHO (2011). Report on the global tobacco epidemic, warning about the dangers of tobacco. Appendix VII: age-standardized prevalence estimates for smoking, 2009.
  62. Zhou W, Heist RS, Liu G, et al (2006). Smoking cessation before diagnosis and survival in early stage non-small cell lung cancer patients. Lung Cancer, 53, 375-80. https://doi.org/10.1016/j.lungcan.2006.05.017

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