Smoking cessation intervention for patients with head and neck cancer: A prospective randomized controlled trial

• Published in: American journal of otolaryngology 2021-01, Vol.42 (1), p.102832-102832, Article 102832
• Main Authors: Smaily, Hussein, Khalaf, Michel, Melkane, Antoine E., Helou, Diane, Richa, Tony, Khoury, Clement, Azoury, Fares, Farha, Georges, Haddad, Amine, Matar, Nayla
• Format: Article
• Language: English
• Subjects: Cancer; Cancer therapies; Cigarette smoking; Clinical trials; Counseling; Disease; Drug addiction; Drug dependence; Drug therapy; Enrollments; Head; Head & neck cancer; Head and neck cancer; Intervention; Mood; Neck; Nicotine; Nicotine patch therapy; Patients; Peer review; Population; Questionnaires; Radiation therapy; Smoking; Smoking cessation; Squamous cell carcinoma; Statistical analysis; Systematic review; Tobacco
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2020.102832

To evaluate the effectiveness of a brief smoking cessation intervention in head and neck cancer patients (HNCP). A prospective randomized controlled trial that randomly assigns participants in two groups: a usual care group (UCG), and a standardized intervention group (SIG). Patients with a confirmed diagnosis of head and neck squamous cell carcinoma (HNSCC) and who are active smokers were prospectively approached by one of 4 trained Ear-nose-throat (ENT) residents. Participants were randomized into a UCG, and a SIG consisting of a brief perioperative smoking cessation intervention based on National Institute of Health (NIH) “5A's” model along with an informative motivational document and nicotine patch therapy (NPT) offered for 8 weeks in gradually decreasing doses. The evaluation of abstinence at 3, 6 and 12 months after enrollment. 56 subjects were randomized into the UCG (N = 29, 52%), and the SIG (N = 27, 48%). The overall smoking cessation rates were not statistically different between the two groups; we observed at 3 months cessation rates of 57.1% vs. 57.7% (p = 0.96); at 6 months, 42.9% vs. 24% (p = 0.148); and at 12 months, 33.3% vs. 20.8% (p = 0.318), for the UCG and the SIG respectively. This study failed to show the effectiveness of a combined brief smoking cessation approach led by and ENT resident in HNSCC patients. A multifaceted approach addressing different pharmacological treatments, factors contributing to smoking maintenance, mainly alcohol dependence and mood disturbances and dealing with relapse risks through close face-to-face or phone call follow-ups may have better outcomes and should be evaluated in upcoming trials.