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Personalized Intervention Program: Tobacco Treatment for Patients at Risk for Lung Cancer

Published online by Cambridge University Press:  11 December 2017

Krysten W. Bold*
Affiliation:
Yale School of Medicine, New Haven, CT
Benjamin A. Toll
Affiliation:
Yale School of Medicine, New Haven, CT Medical University of South Carolina, Charleston, SC Hollings Cancer Center, Charleston, SC
Brenda Cartmel
Affiliation:
Yale School of Public Health, New Haven, CT
Bennie B. Ford
Affiliation:
Yale School of Medicine, New Haven, CT
Alana M. Rojewski
Affiliation:
Medical University of South Carolina, Charleston, SC Hollings Cancer Center, Charleston, SC
Ralitza Gueorguieva
Affiliation:
Yale School of Medicine, New Haven, CT Yale School of Public Health, New Haven, CT
Stephanie S. O'Malley
Affiliation:
Yale School of Medicine, New Haven, CT Yale Cancer Center, New Haven, CT
Lisa M. Fucito
Affiliation:
Yale School of Medicine, New Haven, CT Yale Cancer Center, New Haven, CT Smilow Cancer Hospital at Yale-New Haven, New Haven, CT
*
Address for correspondence: Krysten W. Bold, Yale School of Medicine, Department of Psychiatry, 34 Park Street CMHC-SAC, New Haven, CT. Email: krysten.bold@yale.edu.

Abstract

Background: Lung cancer screening and tobacco treatment for patients at high-risk for lung cancer may greatly reduce mortality from smoking, and there is an urgent need to improve smoking cessation therapies for this population.

Aims: The purpose of this study is to test the efficacy of two separate, sequential interventions to promote tobacco cessation/reduction compared to standard care in smokers considered high-risk for lung cancer.

Methods: The study will recruit 276 current smokers attending a lung cancer screening clinic or considered high-risk for lung cancer based on age and smoking history across two sites. Patients first will be randomized to either standard tobacco treatment (8 weeks of nicotine patch and five individual counselling sessions) or standard tobacco treatment plus personalized gain-framed messaging. At the 8-week visit, all patients will be re-randomized to receive biomarker feedback or no biomarker feedback. Repeated assessments during treatment will be used to evaluate changes in novel biomarkers: skin carotenoids, lung function, and plasma bilirubin that will be used for biomarker feedback. We hypothesize that personalized gain-framed messages and receiving biomarker feedback related to tobacco cessation/reduction will improve quit rates and prevent relapse compared to standard care. Primary outcomes include 7-day point-prevalence abstinence verified with expired carbon monoxide at 8 weeks and mean cigarettes per day in the past week at 6 months.

Conclusions: Study findings will inform the development of novel interventions for patients at risk for lung cancer to improve smoking cessation rates.

Type
Protocol
Copyright
Copyright © The Author(s) 2017 

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References

Bize, R., Burnand, B., Mueller, Y., Rège-Walther, M., Camain, J. Y., & Cornuz, J. (2012). Biomedical risk assessment as an aid for smoking cessation. The Cochrane Library, (12). Art. No: CD004705. DOI: 10.1002/14651858.CD004705.pub4.Google Scholar
Fiore, M. C., Jaen, C. R., Baker, T. B., Bailey, W. C., Benowitz, N. L., Curry, S. J. et al. (2008). Treating tobacco use and dependence: 2008 update clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service.Google Scholar
Galan, P., Viteri, F., Bertrais, S., Czernichow, S., Faure, H., Arnaud, J. et al. (2005). Serum concentrations of β-carotene, vitamins C and E, zinc and selenium are influenced by sex, age, diet, smoking status, alcohol consumption and corpulence in a general French adult population. European Journal of Clinical Nutrition, 59 (10), 11811190.Google Scholar
Mayne, S. T., Cartmel, B., Scarmo, S., Jahns, L., Ermakov, I. V., & Gellermann, W. (2013). Resonance Raman spectroscopic evaluation of skin carotenoids as a biomarker of carotenoid status for human studies. Archives of Biochemistry and Biophysics, 539 (2), 163170.Google Scholar
McClure, J. B. (2001). Are biomarkers a useful aid in smoking cessation? A review and analysis of the literature. Behavioral Medicine, 27 (1), 3747.Google Scholar
McKee, S. A., O'Malley, S., Steward, W. T., Neveu, S., Land, M., & Salovey, P. (2004). How to word effective messages about smoking and oral health: Emphasize the benefits of quitting. Journal of Dental Education, 68 (5), 569573.Google Scholar
National Comprehensive Cancer Network (NCCN) (2017). Guidelines for Patients. Lung Cancer Screening, Version 1.2017. Available from: https://www.nccn.org/patients/guidelines/lung_screening/index.htmlGoogle Scholar
National Lung Screening Trial Research Team (NLSTRT) (2011). Reduced lung-cancer mortality with low- dose computed tomographic screening. New England Journal of Medicine, 365, 395409.Google Scholar
O'Malley, S. S., Wu, R., Mayne, S. T., & Jatlow, P. I. (2014). Smoking cessation is followed by increases in serum bilirubin, an endogenous antioxidant associated with lower risk of lung cancer and cardiovascular disease. Nicotine & Tobacco Research, 16 (8), 11451149.Google Scholar
Scanlon, P. D., Connett, J. E., Waller, L. A., Altose, M. D., Bailey, W. C., Sonia Buist, A. et al. (2000). Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease: The lung health study. American Journal of Respiratory and Critical Care Medicine, 161 (2), 381390.Google Scholar
Schneider, T. R., Salovey, P., Pallonen, U., Mundorf, N., Smith, N. F., & Steward, W. T. (2001). Visual and auditory message framing effects on tobacco smoking. Journal of Applied Social Psychology, 31, 667682.Google Scholar
Toll, B. A., Martino, S., Latimer, A., Salovey, P., O'malley, S., Carlin-Menter, S. et al. (2010). Randomized trial: Quitline specialist training in gain-framed vs standard-care messages for smoking cessation. Journal of the National Cancer Institute, 102 (2), 96106.Google Scholar
Toll, B. A., O'malley, S. S., Katulak, N. A., Wu, R., Dubin, J. A., Latimer, A. et al. (2007). Comparing gain-and loss-framed messages for smoking cessation with sustained-release bupropion: a randomized controlled trial. Psychology of Addictive Behaviors, 21 (4), 534.Google Scholar
U.S. Preventive Services Task Force (USPSTF) (2013). Final Recommendation Statement, Lung cancer screening. December 2013. Available from: http://www.uspreventiveservicestaskforce.org/uspstf13/lungcan/lungcanfact.pdfGoogle Scholar
Webb, M. S., Hendricks, P. S., & Brandon, T. H. (2007). Expectancy priming of smoking cessation messages enhances the placebo effect of tailored interventions. Health Psychology, 26 (5), 598.Google Scholar
World Health Organization. (2012). WHO global report: Mortality attributable to tobacco.Google Scholar