Grant Number:	5R03CA088610-02 Interpret this number
Primary Investigator:	Schnoll, Robert
Organization:	Fox Chase Cancer Center
Project Title:	Smoking Cessation for Head, Neck and Lung Cancer Patient
Fiscal Year:	2001

Continued smoking among cancer patients is associated with poor survival, a greater risk of disease recurrence and a second primary tumor, reduced treatment efficacy, and greater recovery- related complications. Nevertheless, about 50 percent of patients who smoked prior to diagnosis continue to do so following diagnosis/treatment. Despite evidence that hospital- based smoking cessation interventions improve tobacco abstinence rates, cancer patients have largely been neglected as a target population for smoking cessation treatment and research. This empirical gap is surprising since smoking cessation can improve prognosis and enhance quality of life for cancer patients, and can be uniquely effective when delivered in a medical context. The few studies which have assessed the efficacy of smoking cessation treatments for cancer patients have yielded limited data due to the use of small samples and the failure to address possible psychological determinants of smoking. Thus, guided by the research team's Cognitive-Social Health Information- Processing (C-SHIP) model, and influenced by preliminary studies of predictors of continued smoking among cancer patients, this study proposes to assess the impact of an individualized, cognitive-behavioral smoking cessation intervention for patients with head, neck, or lung cancer. This intervention targets cognitive and emotional variables considered predictive of smoking by cancer patients (i.e., perceived risk, self-efficacy, fatalistic beliefs, pros and cons of quitting, emotional distress). Using a randomized prospective design, the aims to be addressed are: Aim 1: To compare an individualized cognitive- behavioral smoking cessation intervention to an AHCPR-consistent, time and attention matched, general health educational treatment for increasing readiness to change (i.e., trans-theoretical model stage measure of intention to quit) and reducing smoking rates (i.e., 30-day point prevalence, number of 24-hour quit attempts, number of cigarettes smoked) in a sample of head, neck, and lung cancer patients; Aim 2: To examine psychological mediators of the effects of the cognitive-behavioral treatment, including risk perceptions, self-efficacy, fatalistic beliefs, pros and cons of quitting, and emotional distress. This study will allow for the assessment of the added benefit of a cognitive-behavioral intervention to the AHCPR minimum standard of care. Further, this study will assess the generalizability of the C-SHIP model to the tobacco control area. Lastly, this study will permit the identification of the psychological variables that underlie smoking abstinence among cancer patients. The data garnered from this study should have wide applicability in allowing for informed decisions concerning the implementation of cognitive- behavioral smoking cessation approaches for cancer patients on a broader scale.




A randomized pilot study of cognitive-behavioral therapy versus basic health education for smoking cessation among cancer patients.
Authors: Schnoll R.A. , Rothman R.L. , Wielt D.B. , Lerman C. , Pedri H. , Wang H. , Babb J. , Miller S.M. , Movsas B. , Sherman E. , et al. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2005 Aug; 30(1), p. 1-11.
PMID: 16097900
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Characteristics of cancer patients entering a smoking cessation program and correlates of quit motivation: implications for the development of tobacco control programs for cancer patients.
Authors: Schnoll R.A. , Rothman R.L. , Newman H. , Lerman C. , Miller S.M. , Movsas B. , Sherman E. , Ridge J.A. , Unger M. , Langer C. , et al. .
Source: Psycho-oncology, 2004 May; 13(5), p. 346-58.
PMID: 15133775
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Comparing cancer patients who enroll in a smoking cessation program at a comprehensive cancer center with those who decline enrollment.
Authors: Schnoll R.A. , Rothman R.L. , Lerman C. , Miller S.M. , Newman H. , Movsas B. , Sherman E. , Ridge J.A. , Unger M. , Langer C. , et al. .
Source: Head & neck, 2004 Mar; 26(3), p. 278-86.
PMID: 14999804
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Longitudinal predictors of continued tobacco use among patients diagnosed with cancer.
Authors: Schnoll R.A. , James C. , Malstrom M. , Rothman R.L. , Wang H. , Babb J. , Miller S.M. , Ridge J.A. , Movsas B. , Langer C. , et al. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2003 Summer; 25(3), p. 214-22.
PMID: 12763716
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Psychological issues related to the use of spiral CT for lung cancer early detection.
Authors: Schnoll R.A. , Bradley P. , Miller S.M. , Unger M. , Babb J. , Cornfeld M. .
Source: Lung cancer (Amsterdam, Netherlands), 2003 Mar; 39(3), p. 315-25.
PMID: 12609570
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Characteristics of female smokers attending a lung cancer screening program: a pilot study with implications for program development.
Authors: Schnoll R.A. , Miller S.M. , Unger M. , McAleer C. , Halbherr T. , Bradley P. .
Source: Lung cancer (Amsterdam, Netherlands), 2002 Sep; 37(3), p. 257-65.
PMID: 12234693
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Correlates of tobacco use among smokers and recent quitters diagnosed with cancer.
Authors: Schnoll R.A. , Malstrom M. , James C. , Rothman R.L. , Miller S.M. , Ridge J.A. , Movsas B. , Unger M. , Langer C. , Goldberg M. .
Source: Patient education and counseling, 2002 Feb; 46(2), p. 137-45.
PMID: 11867244
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Processes of change related to smoking behavior among cancer patients.
Authors: Schnoll R.A. , Malstrom M. , James C. , Rothman R.L. , Miller S.M. , Ridge J.A. , Movsas B. , Langer C. , Unger M. , Goldberg M. .
Source: Cancer practice, 2002 Jan-Feb; 10(1), p. 11-9.
PMID: 11866704
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Measuring supportive and unsupportive responses during cancer treatment: a factor analytic assessment of the partner responses to cancer inventory.
Authors: Manne S. , Schnoll R. .
Source: Journal of behavioral medicine, 2001 Aug; 24(4), p. 297-321.
PMID: 11523330
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Measuring cancer patients' psychological distress and well-being: a factor analytic assessment of the Mental Health Inventory.
Authors: Manne S. , Schnoll R. .
Source: Psychological assessment, 2001 Mar; 13(1), p. 99-109.
PMID: 11281043
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Using disease-related and demographic variables to form cancer-distress risk groups.
Authors: Schnoll R.A. , Harlow L.L. .
Source: Journal of behavioral medicine, 2001 Feb; 24(1), p. 57-74.
PMID: 11296470
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