An Implementation Trial to Improve Tobacco Treatment for Cancer Patients: Patient Preferences, Treatment Acceptability and Effectiveness
Abstract
:1. Introduction
2. Materials and Methods
2.1. Provider and Staff Training
2.2. Participants and Setting
2.3. Recruitment
2.4. Treatment
2.4.1. External Tobacco Treatment Services (PhoneQuit, GroupQuit)
2.4.2. SmartQuit
2.5. Measures
2.5.1. Patient Exit Interviews (PEIs)
2.5.2. Follow-Up Telephone Survey
2.6. Statistical Analysis
3. Results
3.1. Participants
3.2. Reach and Tobacco Treatment Choice
3.3. Smoking Outcomes
3.4. Treatment Use and Acceptability
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | GroupQuit (n = 14) | PhoneQuit (n = 39) | SmartQuit (n = 37) | Total (n = 90) |
---|---|---|---|---|
Age (mean, SD) | 57.3 (6.9) | 60.6 (1.2) | 55.5 (13.1) | 58.0 (10.2) |
Gender | ||||
Male | 4 (28.6%) | 20 (51.3%) | 16 (43.2%) | 40 (44.4%) |
Female | 10 (71.4%) | 19 (48.7%) | 21 (56.8%) | 50 (55.5%) |
Race2 | ||||
White | 9 (64.3%) | 30 (76.9%) | 29 (78.4%) | 68 (75.6%) |
Black/African American | 4 (28.6%) | 8 (20.5%) | 5 (13.5%) | 17 (18.9%) |
Other | 3 (17.0%) | 2 (5.5%) | 4 (10.8%) | 9 (10.0%) |
Ethnicity | ||||
Hispanic | 1 (7.1%) | 0 (0.0%) | 1 (2.7%) | 2 (2.2%) |
Non-Hispanic | 13 (92.9%) | 39 (100.0%) | 36 (97.3%) | 88 (97.8%) |
Marital status | ||||
Married or cohabitating | 6 (42.9%) | 24 (61.5%) | 15 (40.5%) | 45 (50.0%) |
Not married or cohabitating | 8 (57.1%) | 15 (39.5%) | 22 (59.4%) | 45 (50.0%) |
Rurality a | ||||
Urban | 8 (57.1%) | 28 (71.8%) | 26 (70.3%) | 62 (68.9%) |
Rural | 6 (42.9%) | 11 (28.2%) | 11 (29.7%) | 28 (31.1%) |
Cigarette smoking frequency | ||||
Every day | 13 (92.9%) | 30 (76.9%) | 34 (91.9%) | 77 (85.6%) |
Some days | 0 (0.0%) | 7 (17.9%) | 3 (8.1%) | 10 (11.1%) |
E-cigarette use frequency | ||||
Every day | 1 (7.1%) | 1 (2.6%) | 4 (10.8%) | 6 (6.7%) |
Some days | 1 (7.1%) | 10 (25.6%) | 6 (16.2%) | 17 (18.9%) |
Not at all | 11 (78.6%) | 27 (69.2%) | 27 (73.0%) | 65 (72.2%) |
Cigarettes/day (mean, SD) | 20.1 (15.1) | 12.3 (8.5) | 13.8 (12.1) | 14.2 (11.5) |
Age of smoking initiation (mean, SD) | 21.0 (8.1) | 18.9 (6.5) | 16.2 (6.4) | 17.0 (8.0) |
PEI composite score (1–10) | 6.9 (2.9) | 7.2 (2.9) | 7.7 (2.6) | 7.4 (2.7) |
Cancer diagnosis | ||||
Past week | 1 (7.1%) | 2 (5.1%) | 2 (5.4%) | 5 (5.6%) |
Past month | 0 (0.0%) | 4 (10.3%) | 5 (13.5%) | 9 (10.0%) |
Past 1–3 months | 3 (21.4%) | 7 (17.9%) | 4 (10.8%) | 14 (15.6%) |
Past 4–6 months | 3 (21.4%) | 7 (17.9%) | 7 (18.9%) | 17 (18.9%) |
Past 7–12 months | 2 (14.3%) | 2 (5.1%) | 3 (8.1%) | 7 (7.8%) |
Over 12 months | 5 (35.7%) | 17 (43.6%) | 16 (43.2%) | 38 (42.2%) |
Cancer site b | ||||
Lung | 4 (28.6%) | 11 (28.2%) | 11 (29.7%) | 26 (28.9%) |
Head and neck | 5 (35.7%) | 8 (20.5%) | 20 (54.1%) | 33 (36.7%) |
Breast | 0 (0.0%) | 6 (15.4%) | 7 (18.9%) | 13 (14.4%) |
Gastrointestinal | 5 (35.7%) | 11 (28.2%) | 5 (13.5%) | 21 (23.3%) |
Thyroid | 0 (0.0%) | 2 (5.1%) | 0 (0.0%) | 2 (2.2%) |
Genitourinary | 2 (14.3%) | 7 (17.9%) | 3 (8.1%) | 12 (13.3%) |
Gynecologic | 2 (14.3%) | 1 (2.6%) | 2 (5.4%) | 5 (5.5%) |
Bone | 2 (14.3%) | 4 (10.3%) | 3 (8.1%) | 9 (10.0%) |
Brain | 2 (14.3%) | 4 (10.3%) | 1 (2.7%) | 7 (7.8%) |
Hematologic/Blood | 4 (28.6%) | 3 (7.7%) | 4 (10.8%) | 11 (12.2%) |
Other | 1 (7.1%) | 3 (7.7%) | 1 (2.7%) | 5 (5.6%) |
Clinic | Eligible Patients | Enrolled Patients |
---|---|---|
Medical Oncology | 227 | 53 (23.4%) |
Radiation Oncology | 230 | 25 (10.9%) |
ENT | 88 | 12 (13.6%) |
Total | 545 | 90 (16.5%) |
Reason for Treatment Choice | GroupQuit (n = 14) | PhoneQuit (n = 39) | SmartQuit (n = 37) |
---|---|---|---|
I think it would help me to quit | 10 (71.4%) | 18 (46.2%) | 17 (45.9%) |
I tried another method and it didn’t work out | 2 (14.3%) | 1 (2.6%) | 2 (5.4%) |
I know someone who is doing/has done the program | 1 (7.1%) | 0 (0.0%) | 1 (2.7%) |
I don’t have a smartphone | 3 (21.4%) | 7 (17.9%) | -- |
I would like having the group support | 8 (57.1%) | -- | -- |
I would rather talk to someone in-person | 8 (57.1%) | -- | -- |
It would be more convenient for me | -- | 26 (66.7%) | 21 (56.8%) |
I would like having the one-on-one support | -- | 8 (20.5%) | 13 (35.1%) |
I would rather talk to someone on the phone | -- | 15 (38.5%) | 15 (40.5%) |
I would like the fact that I can do it from home | -- | 26 (66.7%) | 21 (56.8%) |
I would like the video interaction with the counselor | -- | -- | 8 (21.6%) |
Other | 2 (14.3%) | 1 (2.6%) | 3 (8.1%) |
GroupQuit (n = 5) | PhoneQuit (n = 18) | SmartQuit (n = 12) | Total (n = 35) | |
---|---|---|---|---|
Treatment utilization | ||||
Received treatment | 3 (60.0%) | 9 (50.0%) | 7 (58.3%) | 19 (54.3%) |
No tobacco treatment | 2 (40.0%) | 9 (50.0%) | 5 (41.7%) | 16 (45.7%) |
7-day abstinence | ||||
Among patients completing follow-up (CCA) (n = 35) | 2 (40.0%) | 3 (16.7%) | 2 (28.6%) | 7 (20.0%) |
Received treatment | 2 (40.0%) | 2 (11.1%) | 1 (8.3%) | 5 (14.3%) |
No treatment | 0 (0.0%) | 1 (5.6%) | 1 (8.3%) | 2 (5.7%) |
Among all patients (ITT) (n = 90) a | 2 (14.3%) | 3 (7.7%) | 2 (5.4%) | 7 (7.8%) |
Mean change in cigarettes/day (SD) | −12.3 (7.5) | −5.0 (6.3) | −4.7 (13.7) | −5.9 (8.9) |
GroupQuit (n = 2) M (SD) | PhoneQuit (n = 11) M (SD) | SmartQuit (n = 4) M (SD) | |
---|---|---|---|
1. How interesting was the tobacco cessation treatment that you received? | 8 (1.4) | 4.0 (2.6) | 9.25 (1.5) |
2. How useful was the treatment that you received from this program? | 4.5 (3.5) | 6.2 (2.6) | 8.75 (2.5) |
3. How much new information did you learn as a result of the treatment that you received from this program? | 3.5 (4.6) | 4.7 (2.6) | 8.5 (3.0) |
4. How easy to understand was the treatment that you received from this program? | 5.0 (7.0) | 8.8 (2.0) | 8.6 (2.5) |
5. How satisfied were you with the treatment you received from this program? | 8.5 (2.1) | 6.7 (2.3) | 10.0 (0.0) |
6. How did this treatment compare with other treatments you have had for smoking cessation in the past? | 0 (0.0) | 5.0 (4.1) | 8.6 (2.5) |
7. How easily available was this program to you compared to other treatments you have had for smoking cessation in the past? | 3.5 (5.0) | 7.0 (4.0) | 8.5 (2.4) |
8. To what extent did the content of this treatment meet your specific needs compared to other treatments you have had for smoking cessation in the past? | 3.5 (5.0) | 6.0 (3.1) | 8.5 (2.4) |
9. To what extent were you able to learn new information that was based on your own personal needs? | 4.5 (6.4) | 5.8 (3.7) | 7.0 (3.5) |
10. To what extent were you concerned about electronic information (for example, privacy issues, sending information over the internet, etc.) as part of treatment? a | 10.0 (0.0) | 10.0 (0.0) | 8.3 (2.4) |
11. To what extent did you want more person-to-person help as part of this treatment? a | 7.5 (3.5) | 5.2 (4.2) | 3.2 (4.7) |
12. How helpful was the treatment in achieving your goals? | 3.5 (5.0) | 6.2 (3.6) | 7.25 (3.2) |
13. How easy to use was this treatment? | 8.5 (.7) | 7.5 (3.9) | 7.5 (5) |
14. How flexible was the treatment in terms of when you could access it? | 8.0 (1.4) | 8.2 (2.4) | 10 (0.0) |
15. Did the treatment help you learn and practice new skills in risky situations? | 3.5 (5.0) | 4.3 (4.8) | 5.8 (5.1) |
16. How likely is it that you would recommend this treatment to a friend? | 5.0 (7.1) | 7.7 (3.9) | 10 (0.0) |
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LeLaurin, J.H.; Dallery, J.; Silver, N.L.; Markham, M.-J.; Theis, R.P.; Chetram, D.K.; Staras, S.A.; Gurka, M.J.; Warren, G.W.; Salloum, R.G. An Implementation Trial to Improve Tobacco Treatment for Cancer Patients: Patient Preferences, Treatment Acceptability and Effectiveness. Int. J. Environ. Res. Public Health 2020, 17, 2280. https://doi.org/10.3390/ijerph17072280
LeLaurin JH, Dallery J, Silver NL, Markham M-J, Theis RP, Chetram DK, Staras SA, Gurka MJ, Warren GW, Salloum RG. An Implementation Trial to Improve Tobacco Treatment for Cancer Patients: Patient Preferences, Treatment Acceptability and Effectiveness. International Journal of Environmental Research and Public Health. 2020; 17(7):2280. https://doi.org/10.3390/ijerph17072280
Chicago/Turabian StyleLeLaurin, Jennifer H., Jesse Dallery, Natalie L. Silver, Merry-Jennifer Markham, Ryan P. Theis, Deandra K. Chetram, Stephanie A. Staras, Matthew J. Gurka, Graham W. Warren, and Ramzi G. Salloum. 2020. "An Implementation Trial to Improve Tobacco Treatment for Cancer Patients: Patient Preferences, Treatment Acceptability and Effectiveness" International Journal of Environmental Research and Public Health 17, no. 7: 2280. https://doi.org/10.3390/ijerph17072280