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From OncoLog, February 2014, Vol. 59, No. 2

Comprehensive Tobacco Treatment Approach Helps Patients Quit on Their Terms

By Kathryn L. Hale

Kicking a tobacco habit is a formidable task. Quitting tobacco after a diagnosis of cancer, a time of great stress, can be even more difficult.

“A small but growing body of evidence indicates that cancer patients who quit smoking after their diagnosis have better medical outcomes.”
– Dr. Paul Cinciripini

An innovative program at The University of Texas MD Anderson Cancer Center offers cancer patients who use tobacco a variety of treatment strategies to quit once and for all.

“A small but growing body of evidence indicates that cancer patients who quit smoking after their diagnosis have better medical outcomes,” said Paul Cinciripini, Ph.D., a professor in the Department of Behavioral Science and the director of the Tobacco Treatment Program.

Based on the theory that cancer patients who smoke may benefit from quitting, MD Anderson’s Tobacco Treatment Program was created in 2006. The program—which is available at no cost to MD Anderson patients who use tobacco or who recently quit—takes a comprehensive approach that offers each participant a menu of counseling and pharmacological options that can be combined in various ways to best meet that individual’s needs. The program is also available to MD Anderson employees, their spouses, and their children 27 years or younger.

Counseling and pharmacotherapy


Psychosocial interventions and counseling are the backbone of the Tobacco Treatment Program. Six full-time staff counselors and two clinical psychologists at the Tobacco Treatment Program provide the counseling. Vance Rabius, Ph.D., an instructor in the Department of Behavioral Science and part of the Tobacco Treatment Program leadership, said, “Counseling might include motivational interviewing for participants who have not yet decided to quit or are struggling to attempt quitting, discussion of barriers to quitting, or development of strategies for quitting or maintaining abstinence.”

Image: Smoking cessation rates

Dr. Rabius said that most patients undergo six to eight counseling sessions, but the number of sessions is flexible. Participants take the lead in deciding how much counseling is needed. While the ideal is on-site, face-to-face sessions, the program also offers counseling sessions via telephone or video conference.

Pharmacotherapy, the other major component of the Tobacco Treatment Program, approximately doubles a tobacco user’s chance of quitting successfully. Dr. Cinciripini said, “Pharmacotherapy often makes the difference between maintaining abstinence and relapsing.”

Pharmacotherapy in the Tobacco Treatment Program may include nicotine replacement therapy, bupropion, and/or varenicline. Because these drugs have different side effects, the therapy is tailored to each patient’s needs.

Current research

Now in its eighth year, the Tobacco Treatment Program is expanding its research and assessment activities. One area of investigation is how the quit rate of the Tobacco Treatment Program’s comprehensive approach stacks up against the quit rates for broader education-based programs.

The Tobacco Treatment Program is also studying the potential for its approach in the community. The program is now accruing participants in clinical trials looking at the efficacy of the comprehensive approach in individuals with psychiatric disorders and in heavy alcohol users. Participants in these studies do not have to be MD Anderson patients.

Another area of investigation is the medical outcomes of cancer patients who participated in the Tobacco Treatment Program. “We’re mature enough as a program that we can go back and look carefully at the medical records of the patients we’ve treated in the past to see how those patients have fared,” Dr. Cinciripini said.

Researchers in the Tobacco Treatment Program will also soon begin a prospective study in patients with lung cancer to determine the effects of the Tobacco Treatment Program on cancer treatment efficacy, quality of life, and survival.

Dr. Cinciripini added that other cancer centers around the world will be watching to see whether the intensive and personalized Tobacco Treatment Program makes a material difference in cancer patients’ survival and quality of life. “What happens here has the potential to affect cancer patients and tobacco users everywhere,” he said.

For more information, contact Dr. Paul Cinciripini at 713-745-1868 and Dr. Vance Rabius at 713-745-4474.

Other articles in OncoLog, February 2014 issue:

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