Grant Number:	4R01CA166147-05 Interpret this number
Primary Investigator:	Park, Elyse
Organization:	Massachusetts General Hospital
Project Title:	Integrating Tobacco Treatment Into Cancer Care
Fiscal Year:	2016

DESCRIPTION (provided by applicant): In response to the Dissemination and Implementation Research in Health PAR 10-38, we propose to examine the integration of two evidence-based tobacco treatments into real-world cancer care settings. Quitting smoking after cancer diagnosis may increase patients' quality of life and improve treatment outcomes through decreases in complications from surgery, radiation or chemotherapy, and decreases in risk of second primary tumors. At diagnosis, approximately 10-30% of cancer patients are smokers, and many have elevated socioeconomic, biologic, and psychosocial vulnerabilities. The U.S. Department of Health and Human Services Public Health Service has evidence-based tobacco treatment guidelines, but these have not been integrated into cancer care. An American Society of Clinical Oncology core quality indicator is identification, advice, and counseling of all smokers by their second cancer visit, but these quality standards are not being met. To address this treatment gap, we propose to conduct the first comparative effectiveness trial to assess the effectiveness of two evidence-based tobacco treatments among newly diagnosed cancer patients. Our proposal is guided by Dr. Park's findings from a nonrandomized controlled pilot study (5R03CA130722-02) which showed promising feasibility and efficacy for delivering an evidence-based Intensive Treatment (IT) to newly diagnosed lung cancer patients at Massachusetts General Hospital (MGH). We propose to enroll 295 current smokers newly diagnosed with lung, colon, breast, or prostate cancer (the four most prevalent cancers) at MGH and Memorial Sloan Kettering Cancer Center (MSK) and compare the differential effectiveness of delivering an Intensive Treatment (IT; 10 motivational counseling sessions plus 12 weeks of FDA approved smoking cessation medication) versus a Brief Treatment (BT; the current treatment provided at MSK, which is 4 motivational counseling sessions plus medication advice). Aim 1 will compare the effectiveness of the two tobacco treatments in promoting biochemically confirmed tobacco abstinence at 6 months. Aim 2 will assess mechanisms through which treatment promotes abstinence, subpopulations in which abstinence is promoted, and aspects of treatment that promote abstinence. Aim 3 will explore how many smokers enroll in, and adhere to, tobacco treatment. This proposal is unique in its 1) theory [(combining a chronic illness (Self-Regulation) and behavior change (Health Belief) model)], 2) integrated tobacco treatments (targeted to patients undergoing cancer treatment), and 3) collaborative care model (sustainable and facilitated through state-of- the art electronic health record systems). Study findings will addres previously unanswered questions about provision of integrated tobacco treatment as part of comprehensive cancer care. Furthermore, it will provide information to lay the groundwork for dissemination efforts into a variety of cancer care settings.




Do Tobacco Treatment Trials Address Disparities in Smoking Outcomes Among Black and Hispanic Cancer Patients? A Systematic Review of Smoking Cessation Interventions for Black and Hispanic Patients Diagnosed with Cancer.
Authors: Perez G.K. , Rabin J.T. , Tandon M. , Strauss N.M. , Irwin K. , Philpotts L. , Ostroff J. , Park E.R. .
Source: Journal of racial and ethnic health disparities, 2024 Aug; 11(4), p. 2390-2406.
EPub date: 2023-07-19.
PMID: 37468742
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Smoking Behaviors Among Black and Hispanic Cancer Patients: A Systematic Review of the Literature.
Authors: Rabin J. , Castelin S. , Strauss N. , Philpotts L.L. , Park E.R. , Perez G. .
Source: Journal of immigrant and minority health, 2023 Aug; 25(4), p. 925-952.
EPub date: 2022-11-01.
PMID: 36318437
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Patients With Serious Mental Illness Can Engage in Tobacco Treatment Trials and Tobacco Cessation Interventions During Cancer Treatment.
Authors: Steffens E.B. , Park E.R. , Muzikansky A. , Streck J.M. , Ostroff J.S. , Rasmussen A.W. , Ponzani C. , Perez G.K. , Regan S. , Rigotti N.A. , et al. .
Source: JCO oncology practice, 2023 Feb; 19(2), p. e238-e247.
EPub date: 2022-11-09.
PMID: 36351206
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Patient-Reported Receipt of Oncology Clinician-Delivered Brief Tobacco Treatment (5As) Six Months following Cancer Diagnosis.
Authors: Price S.N. , Neil J.M. , Flores M. , Ponzani C. , Muzikansky A. , Ballini L. , Ostroff J.S. , Park E.R. .
Source: Oncology, 2023; 101(5), p. 328-342.
EPub date: 2023-03-09.
PMID: 36893738
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Longitudinal Electronic Cigarette Use Among Patients Recently Diagnosed With Cancer Enrolled in a Smoking Cessation Trial.
Authors: Kalkhoran S. , Streck J.M. , Kruse G.R. , Rigotti N.A. , Perez G.K. , Regan S. , Ponzani C.J. , Muzikansky A. , Park E.R. , Ostroff J.S. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2022-06-15; 24(7), p. 970-977.
PMID: 35134988
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Investigating documentation of alcohol and non-medical substance use in oncology treatment: an electronic health record review.
Authors: Streck J.M. , Walter A.W. , Temel J.S. , Jawahri A.E. , Shin H.J. , Regan S. , Muzikansky A. , Ponzani C.J. , Ostroff J.S. , Park E.R. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2022 May; 30(5), p. 4275-4281.
EPub date: 2022-01-28.
PMID: 35088148
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Internalized stigma among cancer patients enrolled in a smoking cessation trial: The role of cancer type and associations with psychological distress.
Authors: Warner E.T. , Park E.R. , Luberto C.M. , Rabin J. , Perez G.K. , Ostroff J.S. .
Source: Psycho-oncology, 2022 May; 31(5), p. 753-760.
EPub date: 2021-11-19.
PMID: 34797953
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Perceived cancer-related benefits of quitting smoking and associations with quit intentions among recently diagnosed cancer patients.
Authors: Hall D.L. , Neil J.M. , Ostroff J.S. , Hawari S. , O'Cleirigh C. , Park E.R. .
Source: Journal of health psychology, 2021 May; 26(6), p. 831-842.
EPub date: 2019-04-29.
PMID: 31035808
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Examining the effects of problematic alcohol use on cigarette abstinence in recently diagnosed cancer patients enrolled in a cessation trial: A secondary analysis.
Authors: Streck J.M. , Hyland K.A. , Regan S. , Muzikansky A. , Rigotti N.A. , Ponzani C.J. , Perez G.K. , Kalkhoran S. , Ostroff J.S. , Park E.R. .
Source: Addictive behaviors, 2021 Apr; 115, p. 106794.
EPub date: 2020-12-29.
PMID: 33385757
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Impact of the COVID-19 pandemic on telehealth research in cancer prevention and care: A call to sustain telehealth advances.
Authors: Park E.R. , Chiles C. , Cinciripini P.M. , Foley K.L. , Fucito L.M. , Haas J.S. , Joseph A.M. , Ostroff J.S. , Rigotti N.A. , Shelley D.R. , et al. .
Source: Cancer, 2021-02-01; 127(3), p. 334-338.
EPub date: 2020-10-13.
PMID: 33048350
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Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer: A Randomized Clinical Trial.
Authors: Park E.R. , Perez G.K. , Regan S. , Muzikansky A. , Levy D.E. , Temel J.S. , Rigotti N.A. , Pirl W.F. , Irwin K.E. , Partridge A.H. , et al. .
Source: JAMA, 2020-10-13; 324(14), p. 1406-1418.
PMID: 33048154
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Patient-Level Factors Associated with Oncology Provider-Delivered Brief Tobacco Treatment Among Recently Diagnosed Cancer Patients.
Authors: Neil J.M. , Price S.N. , Friedman E.R. , Ponzani C. , Ostroff J.S. , Muzikansky A. , Park E.R. .
Source: Tobacco use insights, 2020; 13, p. 1179173X20949270.
EPub date: 2020-08-17.
PMID: 32874095
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Electronic cigarette use patterns and reasons for use among smokers recently diagnosed with cancer.
Authors: Kalkhoran S. , Kruse G.R. , Rigotti N.A. , Rabin J. , Ostroff J.S. , Park E.R. .
Source: Cancer medicine, 2018 Jul; 7(7), p. 3484-3491.
EPub date: 2018-06-14.
PMID: 29905013
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Integrating tobacco treatment into cancer care: Study protocol for a randomized controlled comparative effectiveness trial.
Authors: Park E.R. , Ostroff J.S. , Perez G.K. , Hyland K.A. , Rigotti N.A. , Borderud S. , Regan S. , Muzikansky A. , Friedman E.R. , Levy D.E. , et al. .
Source: Contemporary clinical trials, 2016 Sep; 50, p. 54-65.
EPub date: 2016-07-19.
PMID: 27444428
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