JCO oncology advances · 2026
Reach, Acceptability, and Effectiveness of Proactive Outreach and Varenicline with Cancer-Focused Counseling for Patients with Cancer: A Pilot Randomized Comparative Effectiveness Trial.
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Kaye Jesse T, Piasecki Thomas M, Fiore Michael C, Baker Timothy B, Zehner Mark E, Williams Brian S, Slutske Wendy S, McCarthy Danielle E
Аннотация
PURPOSE: More research is needed on the acceptability and effectiveness of cigarette smoking cessation treatments for patients with cancer. This pilot comparative effectiveness trial contrasted varenicline therapy combined with cancer-focused counseling versus standard smoking cessation treatment to assess the reach, acceptability, and preliminary effectiveness of targeted treatment offered proactively to adult patients with cancer.
PATIENTS AND METHODS: Electronic health records identified adult patients via quarterly reports (January-September, 2024) with cancer diagnoses who smoked tobacco in the past year (N=574) for tobacco use treatment outreach. Eligible patients were enrolled from March-November, 2024, in an effectiveness trial comparing standard smoking cessation treatment (2w nicotine patch + 3 counseling calls) with enhanced treatment (12w varenicline + 7 cancer-targeted counseling calls). Follow-up outcome calls were conducted 12- and 26-weeks after a target quit date. Participants reporting no smoking at 26 weeks post-quit were asked to provide a saliva or breath sample to confirm abstinence.
RESULTS: Among patients eligible at the time of phone outreach (n=406), 52 (12.8%) enrolled in the trial. In both Standard Care (n=26) and Enhanced Care (n=26), at least 23 (88.5%) participants completed some counseling and received study medications. Satisfaction ratings were higher in Enhanced than Standard Care. At 12 weeks post-quit, self-reported 7-day point prevalence abstinence was reported by 6 (23.1%) Standard Care and 9 (34.6%) Enhanced Care participants (OR 1.76, 95%CI 0.52, 5.97). At 26-weeks post-quit, 2 (7.7%) Standard Care and 7 (26.9%) Enhanced Care participants had biochemically confirmed abstinence (OR: 4.4, 95%CI, 0.82-23.8).
CONCLUSION: This pilot study produced evidence supporting the reach, acceptability, and potential effect sizes of enhanced and cancer-focused smoking cessation counseling and medication treatment for adult patients with cancer.
PATIENTS AND METHODS: Electronic health records identified adult patients via quarterly reports (January-September, 2024) with cancer diagnoses who smoked tobacco in the past year (N=574) for tobacco use treatment outreach. Eligible patients were enrolled from March-November, 2024, in an effectiveness trial comparing standard smoking cessation treatment (2w nicotine patch + 3 counseling calls) with enhanced treatment (12w varenicline + 7 cancer-targeted counseling calls). Follow-up outcome calls were conducted 12- and 26-weeks after a target quit date. Participants reporting no smoking at 26 weeks post-quit were asked to provide a saliva or breath sample to confirm abstinence.
RESULTS: Among patients eligible at the time of phone outreach (n=406), 52 (12.8%) enrolled in the trial. In both Standard Care (n=26) and Enhanced Care (n=26), at least 23 (88.5%) participants completed some counseling and received study medications. Satisfaction ratings were higher in Enhanced than Standard Care. At 12 weeks post-quit, self-reported 7-day point prevalence abstinence was reported by 6 (23.1%) Standard Care and 9 (34.6%) Enhanced Care participants (OR 1.76, 95%CI 0.52, 5.97). At 26-weeks post-quit, 2 (7.7%) Standard Care and 7 (26.9%) Enhanced Care participants had biochemically confirmed abstinence (OR: 4.4, 95%CI, 0.82-23.8).
CONCLUSION: This pilot study produced evidence supporting the reach, acceptability, and potential effect sizes of enhanced and cancer-focused smoking cessation counseling and medication treatment for adult patients with cancer.