TY - JOUR
T1 - Efficacy of a Smoking Cessation Intervention for Survivors of Cervical Intraepithelial Neoplasia or Cervical Cancer
T2 - A Randomized Controlled Trial
AU - Vidrine, Jennifer I.
AU - Sutton, Steven K.
AU - Wetter, David W.
AU - Shih, Ya Chen Tina
AU - Ramondetta, Lois M.
AU - Elting, Linda S.
AU - Walker, Joan L.
AU - Smith, Katie M.
AU - Frank-Pearce, Summer G.
AU - Li, Yisheng
AU - Jones, Sarah R.
AU - Kendzor, Darla E.
AU - Simmons, Vani N.
AU - Vidrine, Damon J.
N1 - Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2023/5/20
Y1 - 2023/5/20
N2 - PURPOSEWomen 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.METHODSWomen 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.RESULTSThere 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).CONCLUSIONMAPS 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.
AB - PURPOSEWomen 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.METHODSWomen 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.RESULTSThere 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).CONCLUSIONMAPS 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.
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U2 - 10.1200/JCO.22.01228
DO - 10.1200/JCO.22.01228
M3 - Article
C2 - 36921237
AN - SCOPUS:85159765589
SN - 0732-183X
VL - 41
SP - 2779
EP - 2788
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 15
ER -