image: Dr. Eyse Park, the lead researcher for the Stop Smoking 2.0 clinical trial, notes: "It can be challenging to stop smoking, but if patients continue to smoke through cancer treatment, they are at risk of having complications, which can affect their quality of life." view more
Credit: Massachusetts General Hospital
A research study by the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) is evaluating the use of video counseling nationwide to help cancer patients who smoke to quit and stay smoke-free. Up to 30% of cancer patients are smoking tobacco at the time of diagnosis, and the majority continue to smoke. Counseling to help patients stop smoking is not part of standard care for cancer. This is a particular concern in community-based hospitals and clinics, which care for 80% of all cancer patients in the US.
In the outbreak of the new coronavirus disease, COVID-19, cancer patients are at high risk of severe respiratory illness from infection because cancer and its treatments weaken their immune systems. The World Health Organization cautions that smokers are likely to be more vulnerable to COVID-19 as smoking behavior means that fingers (and possibly contaminated cigarettes) are in contact with lips, which increases the possibility of transmission of the virus from hand to mouth. Smokers may also already have lung disease or reduced lung capacity, which would significantly increase the risk of developing a respiratory illness.
"It can be challenging to stop smoking, but if patients continue to smoke through cancer treatment, they are at risk for having complications, which can affect their quality of life," said lead investigator Elyse R. Park, PhD, MPH, a psychologist researcher at Massachusetts General Hospital.
"This trial offers sustained counseling delivered remotely, and nicotine replacement medicine, which is what we have found will help cancer patients quit smoking tobacco," said Dr. Park.
In this trial, called the Smoke-Free Support Study 2.0, about 308 current smokers (with any type of cancer) will be randomly assigned (by a computer) into one of two study groups. One study group will receive 11 video counseling sessions with a tobacco treatment counselor from the Massachusetts General Hospital in Boston. Patients will have the option to receive up to 12 weeks of standard nicotine replacement therapy (patches and lozenges) at no cost. The other study group will receive stop-smoking advice and referral to the national smokers' quitting resource, smokefree.gov.
Colleagues from Massachusetts General Hospital and Memorial Sloan Kettering (MSK) Cancer Center in New York City collaborated to develop the program.
The primary endpoint of this trial is abstinence at six months. "If the group that receives video counseling has a higher abstinence rate at six months than the usual care group, this trial will meet its primary endpoint," said Dr. Park. "If positive, this trial will help provide the evidence needed to make tobacco treatment a standard of high-quality care in community cancer centers."
In addition, "this trial is collecting data from participating oncology care providers, which will help us identify barriers and facilitators of implementing tobacco treatment in community oncology settings," said Jamie S. Ostroff, PhD, a behavioral scientist at MSK. Dr. Ostroff is a co-investigator for the trial.
The National Cancer Institute (NCI), part of the National Institutes of Health (NIH), is funding the study. The hospitals participating in this trial are all members of the NCI Community Oncology Research Program (NCORP). NCORP is a network of community hospitals throughout the US. More hospitals are joining the trial on a rolling basis.
"We expect to be able to generalize the findings from the Smoke-Free Support Study 2.0 to the broader population of adults with cancer," said Lynne I. Wagner, PhD, of Wake Forest University, who is Deputy Chair of ECOG-ACRIN's Cancer Control and Outcomes Research Program. "In doing so, we advance ECOG-ACRIN's mission to reduce the burden of cancer and improve the quality of life and survival in patients with cancer."
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The full trial name is Implementing a Virtual Tobacco Treatment for Cancer Patients in Community Oncology Practices: "Smoke-Free Support Study 2.0". The trial ID is EAQ171CD. For more information, visit https://ecog-acrin.org/clinical-trials/eaq171cd-educational-materials.
About the ECOG-ACRIN Cancer Research Group
The ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) is a membership-based scientific organization that designs and conducts cancer research involving adults who have or are at risk of developing cancer. ECOG-ACRIN comprises nearly 1100 member institutions in the United States and around the world. Approximately 12,000 physicians, translational scientists, and associated research professionals from the member institutions are involved in Group research, which is organized into three scientific programs: Cancer Control and Outcomes, Therapeutic Studies, and Biomarker Sciences. ECOG-ACRIN is supported primarily through National Cancer Institute research grant funding, but also receives funding from private sector organizations through philanthropy and collaborations. Its headquarters are in Philadelphia, Pa. For more information, visit http://www.ecog-acrin.org, follow us on Twitter @eaonc, Facebook, and LinkedIn, or call 215.789.3631.