A smoking cessation and pain management program for cancer survivors
Many cancer survivors continue to smoke. Further, most survivors also report high levels of persistent pain and smoke in response to pain. The investigators tested the feasibility, acceptability, and preliminary efficacy of a smoking cessation program paired with a pain management program for cancer survivors.
The investigators conducted a two-arm, wait-list randomized controlled pilot study in which they delivered a combined smoking cessation and pain management intervention.
The investigators randomized 30 survivors (14 intervention and 16 wait-list control). Seventy-one percent of the survivors who received the intervention rated it as extremely useful (5 out of 5) in helping them quit smoking. Further, 86% would recommend the program to other survivors. Although we could not conduct inferential statistics, 14% of those in the intervention arm, compared to 6% in the control condition had biochemically validated cessation at 2-months post-randomization. Survivors in the intervention also reported less pain, had improvements in depressive symptoms, and better physical function than those in the control arm.
Our pilot data suggest the feasibility, acceptability, and preliminary efficacy of this approach. The next step is to conduct a large randomized controlled trial to fully test the efficacy of the intervention.
Implications for Cancer Survivors
A combined smoking cessation and pain program might help improve both issues simultaneously.
KeywordsCancer Oncology Pain Smoking cessation Survivors
This study was funded by Duke Cancer Institute.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
This study was approved by the IRB at Duke University School of Medicine. Approval no. Pro00060925.
- 10.Rietman JS, Dijkstra PU, Debreczeni R, Geertzen JH, Robinson DP, De Vries J. Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery. Disabil Rehabil. 2004;26(2):78–84. https://doi.org/10.1080/09638280310001629642.CrossRefPubMedGoogle Scholar
- 20.Patterson AL, Gritzner S, Resnick MP, Dobscha SK, Turk DC, Morasco BJ. Smoking cigarettes as a coping strategy for chronic pain is associated with greater pain intensity and poorer pain-related function. J Pain. 2012;13(3):285–92. https://doi.org/10.1016/j.jpain.2011.11.008.CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Schnoll RA, Zhang B, Rue M, Krook JE, Spears WT, Marcus AC, et al. Brief physician-initiated quit-smoking strategies for clinical oncology settings: a trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol. 2003;21(2):355–65. https://doi.org/10.1200/jco.2003.04.122.CrossRefPubMedGoogle Scholar
- 24.Schnoll RA, Rothman RL, Wielt DB, Lerman C, Pedri H, Wang H, et al. A randomized pilot study of cognitive-behavioral therapy versus basic health education for smoking cessation among cancer patients. Ann Behav Med. 2005;30(1):1–11. https://doi.org/10.1207/s15324796abm3001_1.CrossRefPubMedGoogle Scholar
- 27.Park ER, Ostroff JS, Perez GK, Hyland KA, Rigotti NA, Borderud S, et al. Integrating tobacco treatment into cancer care: study protocol for a randomized controlled comparative effectiveness trial. Contemp Clin Trials. 2016;50:54–65. https://doi.org/10.1016/j.cct.2016.07.016.CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict. 1991;86(9):1119–27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x.CrossRefPubMedGoogle Scholar
- 35.Somers TJ, Blumenthal JA, Guilak F, Kraus VB, Schmitt DO, Babyak MA, et al. Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study. Pain. 2012;153(6):1199–209. https://doi.org/10.1016/j.pain.2012.02.023.CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Bastian LA, Fish LJ, Peterson BL, Biddle AK, Garst J, Lyna P, et al. Assessment of the impact of adjunctive proactive telephone counseling to promote smoking cessation among lung cancer patients’ social networks. Am J Health Promot. 2013;27(3):181–90. https://doi.org/10.4278/ajhp.101122-QUAN-387.CrossRefPubMedGoogle Scholar
- 38.Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville: U.S. Department of Health and Human Services. Public Health Service; 2008.Google Scholar