Good effect of smoking cessation programmes among cancer patients
A combined offer of individual follow-up and free nicotine replacement products can be of great help to cancer patients who wish to stop smoking. This is shown by a study from NIPH.
This article was published in Norwegian on the 28th of February 2023.
Cancer patients who smoke during treatment have a poorer effect from their treatment as patients who do not smoke. Quitting smoking can therefore improve treatment and reduce side effects for this group. A previously published knowledge summary concluded that intensive smoking cessation programmes with several components such as drug treatment, behavioural counselling and social support can be effective.
Although Norwegian hospitals offer various forms of smoking cessation, there have been no studies of the effect of offering such structured and combined smoking cessation programmes to cancer patients at Norwegian hospitals. With funding from the Cancer Association, researchers at the Centre for the Evaluation of Public Health Measures have investigated the effect of offering individual follow-up and free nicotine replacement products to cancer patients undergoing treatment.
Motivational interview combined with free nicotine replacement
All participants in the intervention group (those who were offered the study's smoking cessation programme) were offered smoking cessation guidance based on a motivational interview, in combination with a free nicotine replacement product. Each of the six hospitals that took part in the study received job resources to carry out the guidance. The number of individual consultations varied according to the patients' needs.
– The first consultation was physical and one-on-one, and took place before the cancer treatment began. Further consultations were planned individually to suit the patient, says researcher Elisabeth Kvaavik.
The participants in the control group could go on to participate in what was initially offered as a smoking cessation offering at the various hospitals. This varied between hospitals, from those that had no offer to those that offered various nicotine replacement products.
Recruitment and database
The participants in the study were recruited from cancer departments at six Norwegian hospitals. Smoking status was assessed at the first visit and the responsible physician assessed which patients could be recruited to the study. The participants in the control group (n=208) were recruited in the period September 2017 to February 2019, while the participants in the intervention group (n=232) were recruited from March 2019 to March 2020.
All participants filled in the first questionnaire together with a nurse or radiotherapist, with questions including background, smoking behaviour and smoking history. A follow-up form was filled in by the participants half a year later, using a digital online form or during a telephone call from staff at the hospital.
There were some challenges in recruiting participants to the intervention group. Furthermore, there were also some challenges in obtaining follow-up data. Since there was a greater chance that those who did not quit smoking would not complete the follow-up questions, a robustness test was included with the hypothesis that those who had smoked in the first answer form and did not complete the final questions, were still smoking.
Effect of the programme
The results show that in both study groups, fewer people smoked daily after 6 months than at the start of the study, but there were significantly fewer people who smoked in the intervention group in the follow-up survey six months later. The effect of the combined smoking cessation programme was measured at 13% (18% when adjusted for sex, age, education, work participation, marital status and hospital).
– Providing a tailored offer based on motivational interviews and free nicotine replacement products to cancer patients seems to be effective in getting more people to undergo treatment to stop smoking, says Kvaavik.