Efficacy of a Tobacco Quitline among Adult Survivors of Childhood Cancer
Menée auprès de 519 adultes ayant survécu à un cancer pédiatrique, cette étude compare, du point de vue du taux de sevrage tabagique à 12 mois, l'efficacité de deux programmes d'interventions comportant des séances de conseils téléphoniques et un traitement substitutif nicotinique
Introduction : The purpose of the present investigation was to determine the efficacy of two evidence-based tobacco quitlines in adult survivors of childhood cancer who regularly smoke cigarettes. Methods : A total of 519 adult survivors of childhood cancer were randomized to either Proactive+4 weeks of medication (Counselor initiated intervention, n = 260) or a Reactive+2 weeks of medication (Participant initiated intervention, n = 259) condition. Both conditions received telephone counseling to quit smoking as well as nicotine replacement therapy. The primary outcome was biochemically verified (i.e., cotinine) point prevalence smoking cessation at 12 months follow-up. Results : Participants randomized to the Proactive+4 weeks of medication condition self-reported a higher rate of cessation than those survivors in the Reactive+2 weeks of medication condition at 8 weeks (33.2% versus 17.0%, p<0.001), but cessation rates were not significantly different at 12 months (23.0% versus 18.7%, p=0.29). However, 80% of participants claiming abstinence failed biochemical verification, indicating marked falsification of self-reported smoking status. Adjusted cessation rates were less than 2% in both intervention conditions. Conclusions : Our results indicate that neither a Proactive+4 weeks of medication or Reactive+2 weeks of medication QL significantly impacted long-term smoking cessation rates. Our results further indicate that self-reports of smoking status are unreliable in survivors of childhood cancer, a population in considerable need of tobacco abstinence. Rates of smoking cessation may be markedly overestimated in studies of childhood cancer survivors that rely on self-reports of tobacco abstinence, and future studies need to include biochemical verification of tobacco status in this population.