Smoking Cessation by Combined Medication and Counselling in Lung Cancer Patients Effectiveness in A High Prevalence Real Life Setting

Abstract

Background Smoking cessation in patients with diagnosed lung cancer has positive effects on cancer therapy and overall prognosis. Despite this, knowledge on smoking cessation in lung cancer patients is sparse. Methods This is an observational single centre, 12-week, prospective, single-arm trial at a tertiary lung cancer centre. Patients were enrolled following confirmed lung cancer diagnosis. Smoking cessation intervention included counselling as well as pharmacotherapy. The primary endpoint was the abstinence rate at week 12 based on biochemical verification. Secondary endpoints were the abstinence rate at week 26, quality of life and side effects. Results 80 patients were enrolled. Mean age was 62,6 ± 7,9 years. Most patients (63%) were treated with chemotherapy or radiochemotherapy. 39 patients used nicotine replacement therapy, 35 varenicline whereas six patients did not use pharmacotherapy. During the study period 13 patients died. Data were available in 58 patients after 12 weeks and 52 patients at week 24. Point prevalence abstinence rates were 37.5 percent (95% CI 26.4%-49.7%) at week 12 and 32.8 percent (95% CI 21.8%-45.4%) at week 26, respectively. Quality of life and side effects were not significantly affected by pharmacotherapy. Conclusion In conclusion, our results suggest that smoking cessation is feasible in patients with newly diagnosed lung cancer. The observed abstinence rate is comparable with other patient cohorts. Furthermore, pharmacotherapy in addition to cancer therapy was safe and did not show novel side effects in these seriously ill patients. Thus, smoking cessation should be an integral part of lung cancer treatment. Trial registration: The study was conducted in accordance with good clinical practice standards (GCP) and approved by the local ethics committee (16/3/14), the European PAS registry (EUPAS8748) and the German BfArM (NIS-Studien-Nr. 5508). All patients provided written informed consent before study enrollment.