Comprehensive Tobacco Treatment Approach Helps Patients Quit on Their Terms
By Kathryn L. Hale
a tobacco habit is a formidable task. Quitting tobacco after a
diagnosis of cancer, a time of great stress, can be even more
|“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.”
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
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.
information, contact Dr. Paul Cinciripini at 713-745-1868 and Dr. Vance Rabius at 713-745-4474.
articles in OncoLog, February 2014 issue:
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