Efficacy of a Smoking Cessation Intervention for Survivors of Cervical Intraepithelial Neoplasia or Cervical Cancer: A Randomized Controlled Trial.

Autor:	Vidrine JI; Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.; Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL.; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL., Sutton SK; Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL.; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL.; Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL., Wetter DW; Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, UT., Shih YT; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX., Ramondetta LM; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX., Elting LS; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX., Walker JL; Department of Obstetrics and Gynecology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK., Smith KM; Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK., Frank-Pearce SG; TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK.; University of Oklahoma Health Sciences Center, Oklahoma City, OK.; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK., Li Y; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX., Jones SR; Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL., Kendzor DE; TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK.; University of Oklahoma Health Sciences Center, Oklahoma City, OK.; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK., Simmons VN; Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.; Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL.; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL., Vidrine DJ; Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL.
Jazyk:	angličtina
Zdroj:	Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2023 May 20; Vol. 41 (15), pp. 2779-2788. Date of Electronic Publication: 2023 Mar 15.
DOI:	10.1200/JCO.22.01228
Abstrakt:	Purpose: Women who smoke and have a history of cervical intraepithelial neoplasia (CIN) or cervical cancer represent a vulnerable subgroup at elevated risk for recurrence, poorer cancer treatment outcomes, and decreased quality of life. The purpose of this study was to evaluate the long-term efficacy of Motivation And Problem Solving (MAPS), a novel treatment well-suited to meeting the smoking cessation needs of this population. Methods: Women who were with a history of CIN or cervical cancer, age 18 years and older, spoke English or Spanish, and reported current smoking (≥100 lifetime cigarettes plus any smoking in the past 30 days) were eligible. Participants (N = 202) were recruited in clinic in Oklahoma City and online nationally and randomly assigned to (1) standard treatment (ST) or (2) MAPS. ST consisted of repeated referrals to a tobacco cessation quitline, self-help materials, and combination nicotine replacement therapy (patch plus lozenge). MAPS comprised all ST components plus up to six proactive telephone counseling sessions over 12 months. Logistic regression and generalized estimating equations evaluated the intervention. The primary outcome was self-reported 7-day point prevalence abstinence from tobacco at 18 months, with abstinence at 3, 6, and 12 months and biochemically confirmed abstinence as secondary outcomes. Results: There was no significant effect for MAPS over ST at 18 months (14.2% v 12.9%, P = .79). However, there was a significant condition × assessment interaction ( P = .015). Follow-up analyses found that MAPS ( v ST) abstinence rates were significantly greater at 12 months (26.4% v 11.9%, P = .017; estimated OR, 2.60; 95% CI, 1.19 to 5.89). Conclusion: MAPS led to a greater than two-fold increase in smoking abstinence among survivors of CIN and cervical cancer at 12 months. At 18 months, abstinence in MAPS declined to match the control condition and the treatment effect was no longer significant.
Databáze:	MEDLINE
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