Table S1—[Section 2.0] PICO Question Table – LC III Guidelines
Section
Identification /
Initiation of
Cancer
Treatment
Informal
Questions
Cessation Induction
Exposure Reduction
(primary)
Population
Surgical Resection
PICO Question
Intervention (s) Comparator
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Any / None
Resectability
Curative resection
rates
Complication Rates
(respiratory
complications, wound
infections)
Recurrence Rates
Survival
Chemotherapy
Response Rates
Adverse Events
Survival
HR-QOL / Depression
XRT
Response Rates
Adverse Events
Survival
HR-QOL / Depression
Surgical Resection
Chemotherapy
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Any / None
Surgical Resection
Chemotherapy
XRT
Resectability
Curative resection
rates
Complication Rates
Recurrence Rate
Survival
Study
Methods
RCT
Cohort
Case-Control
Secular Trends
Case Series
RCT
Cohort
Case-Control
Secular Trends
Case Series
Response Rates
Adverse Events
Survival
HR-QOL / Depression
XRT
Exposure Reduction
(secondary - ETS)
Outcome
Response Rates
Adverse Events
Survival
HR-QOL / Depression
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Any / None
Resectability
Curative resection
rates
Complication Rates
Recurrence Rate
Survival
Response Rates
Adverse Events
Survival
HR-QOL / Depression
Response Rates
Adverse Events
Survival
HR-QOL / Depression
RCT
Cohort
Case-Control
Secular Trends
Case Series
Section
During
Primary /
Maintenance
Cancer
Treatment
Informal
Questions
Cessation Induction
Population
Any / None
Response Rates
Adverse Events
Survival
HR-QOL / Depression
RCT
Cohort
Case-Control
Secular Trends
Case Series
Chemotherapy / XRT
/ Combination
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Any / None
Response Rates
Adverse Events
Survival
HR-QOL / Depression
RCT
Cohort
Case-Control
Secular Trends
Case Series
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Any / None
Response Rates
Adverse Events
Survival
HR-QOL / Depression
Second primary tumor
rates
RCT
Cohort
Case-Control
Secular Trends
Case Series
Exposure Reduction
(primary)
Exposure Reduction
(secondary - ETS)
In Remission
Study
Methods
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Exposure Reduction
(primary)
Cessation Induction
Outcome
Chemotherapy / XRT
/ Combination
Exposure Reduction
(secondary - ETS)
During
Salvage
Therapy
PICO Question
Intervention (s) Comparator
Cessation Induction
Exposure Reduction
(primary)
Exposure Reduction
(secondary - ETS)
Cancer
patients who
fail initial
tobacco use
treatment
Abstinence Rates
Any Cancer
Treatment Stage
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Dose Modification
Duration Modification
Counseling Format
(Amount of contact
time, number of
sessions, counseling
type / framework)
Any / None
Abstinence Recovery
Rates
Exposure Reduction
(e.g. cpd)
HR-QOL / Depression
RCT
Cohort
Case-Control
Secular Trends
Case Series
Cancer
patients who
relapse to
smoking
Abstinence Recovery
Any Cancer
Treatment Stage
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Counseling)
Dose Modification
Duration Modification
Counseling Format
(Amount of contact
time, number of
sessions, counseling
type / framework)
Any / None
Abstinence Recovery
Rates
Exposure Reduction
(e.g. cpd)
HR-QOL / Depression
RCT
Cohort
Case-Control
Secular Trends
Case Series
Lung Cancer
Screening
patients /
Pulmonary
Nodule
Patients
Abstinence Rates
Cancer Screening /
Suspicion
Any (Nicotine
Replacement Therapy
[patches, gum,
lozenges, inhaler,
nasal spray],
Bupropion,
Varenicline,
Combination
Pharmacotherapy,
Any / None
Abstinence Recovery
Rates
Exposure Reduction
(e.g. cpd)
HR-QOL / Depression
RCT
Cohort
Case-Control
Secular Trends
Case Series
Counseling)
Dose Modification
Duration Modification
Counseling Format
(Amount of contact
time, number of
sessions, counseling
type / framework)
Table S2. LDCT Screening and Smoking Behavior
Reference
Setup
Setting
Intervention
Study
design
(cited by
author or
actual)
Retrospective
Cohort
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
Numbers
Current
smokers at
time of
baseline
screening
CT, who did
not receive
a diagnosis
of cancer,
and who
survived the
first year
following
screening.
Encouraged
active
smokers to
quit and
recommended
a hospitalbased small
group quit
smoking
program.
Any quit
attempt,
regardless of
duration
Any >30
day quit
interval
since
screening;
Any >30
day quit
interval with
abstinence
at 1 year.
2,094
Any quit atte
No referral
(54.1%) vs.
suspicion re
(61.2%) vs.
Moderate or
suspicion re
(73.7%).
Abstinence a
year: No refe
(13.8%) vs.
suspicion re
(15.3%) vs.
Moderate or
suspicion re
(25.6%).
Styn, 20091
Single
institution,
academic
medical
center
Anderson,
20092 a
Single
institution,
academic
medical
center
CrossSectional
Analysis
Current and
former
smokers
participating
in the Early
Lung
Cancer
Action
Program
screening
trial.
Symptomfree
volunteers,
>10 pk-yr
hx of
cigarette
smoking; no
prior cancer
hx; fit to
undergo
thoracic
surgery.
None
Self-report 30day point
prevalence
abstinence
"New" quit
or
continued
abstinence
2,078
Positive CT
screen resul
associated w
point prevale
abstinence a
follow-up (H
1.39, 95% C
1.01-1.90).
There was n
difference in
of relapse am
former smok
and recent
quitters base
CT screen re
(HR 0.51; 95
0.20-1.29)
Cox, 20032
Single
institution,
academic
medical
center
CrossSectional
Analysis
At least 50
years old;
Enrolled in
CT
screening
study;
Current or
former
smoker; At
least 20
pack year
history.
N/A
7-day point
prevalence
abstinence
rates at 1 year
N/A
901
current
+ 574
former
smokers
In current
smokers, CT
screening
outcome /
recommenda
did not predi
abstinence
(p=0.65); Am
former smok
longer durat
abstinence a
baseline visi
associated w
an increased
likelihood of
abstinence a
1-year follow
(OR 1.6;
p<0.001)
MacRedmond,
20064
Cohort study
Age>50; at
least 10
pack years
of smoking:
still
smoking at
age 45, no
prior
cancer;
medically fit
for thoracic
surgery
Smoking
cessation
advice at
each visit
Smoking
abstinence at
2-years
NA
449
Schnoll,
20025
Lung
Cancer
early
detection
program at
single,
academic
center
Case series
Current
smoker (>
10 cigs per
day); Heavy
smoker (at
least 15 pk
yr hx;
Female; No
personal
history of
cancer)
Advice to quit
smoking +
information
regarding
local
cessation
programs
Psychometric
characteristics
of population
Correlates
of
motivation
to quit; 7day point
prevalence
abstinence
rates at 1month
55
39 available
month follow
9 abstinent.
Clark, 20046
Lung
Cancer CT
screening
program at
single,
academic
center
RCT of two
smoking
cessation
interventions
Received
written selfhelp materials
consisting of
either
internet-based
resources
(N=85) or
standard
smoking
cessation
information
(N=86).
7-day point
prevalence
abstinence
rates at 1 year
Stage of
change
171
Abstinence:
Internet vs. 4
Standard
(p="NS"); Ac
stage: 9/58
Internet vs. 4
Standard
(p="NS")
Ashraf, 20097
Lung
Cancer
Screening
Trial
comparing
annual
screening
with LDCT
or no
intervention
RCT of lung
cancer
screening
At least 50
years old;
Enrolled in
CT
screening
study;
Current
smoker; At
least 20 pk
yr hx; No
personal
history of
cancer
within 5
years;
Access to
computer
with internet
services.
Men and
women
aged 50-70
yrs; no lung
cancerrelated
symptoms;
Current or
ex-smokers
with a
history of at
least 20
pack-years;
Ex-smokers
had to have
quit
Participants
received
minimal
smoking
cessation
counselling
(<5 minutes)
at each
annual visit.
Smoking
abstinence at
1 year
Relapse
among exsmokers
4104
2052 random
to CT; 2052
randomized
control group
smoking
after the
age of 50
years and
less than 10
years ago.
Aalst, 20108
Lung
Cancer
Screening
Trial
comparing
annual
screening
with LDCT
or no
intervention
RCT of lung
cancer
screening
aNo formal cessation advice or counseling.
Participants
received a
standard
smoking
cessation
brochure or a
questionnaire
by which
people could
ask for
tailored
smoking
cessation
information
from
STIVORO,
the Dutch
expert centre
on tobacco
control
Smoking
abstinence at
mean interval
of 2.2 years
after
randomization
Predictors
of
prolonged
smoking
abstinence
1284
Sub-study o
NELSON:
random subg
of current m
smokers
randomized
the sreen
(N=641) or
control arm
(N=643).
Spontaneous quit.
Table S3. Screening high risk populations accompanied by intensive cessation
interventions
Reference
Setup
Setting
Parkes,
20089
Five general
practices in
Hertfordshire,
England
Anthonisen,
200510
10 clinical
centers in the
United States
and Canada
Intervention
Study
design
(cited
by
author
or
actual)
RCT
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
Numbers
35 years
and older;
recorded
as
smokers in
previous
12 months
In addition to
advice to quit Intervention:
spirometry
presented as
"Lung Age";
Control:
spirometry
presented as
FEV1 without
explanation.
Biochemically
confirmed
abstinence at
12 months
Changes in
daily
consumption
of cigarettes
281 Control,
280
Intervention
Abstinence
rates:
Intervention
13.6% vs.
Control
6.4%
(p=0.005)
RCT
Smokers;
Evidence
of airway
obstruction
on
spirometry
Strong physician
advice to quit +
12 2-hour group
session
behavioral
modification +/nicotine gum
All cause
mortality
5-year
abstinence
rates
5887 total
(3923
Intervention,
1964
Control)
Abstinence:
Intervention
21.7% vs.
Control
5.4%
Osinubi,
200311
Subjects
recruited
from workers
attending
screening
activities for
asbestosrelated
diseases.
RCT
Current
smokers
Control: brief
advice to quit +
referral to
physician;
Intervetnion:
"Free and Clear"
phone counseling
including
recommendations
for NRT
One month
point
prevalence
abstinence at
6 months
Changes in
daily
consumption
of cigarettes
29 Control,
30
Intervention
ITT
analysis:
Intervention
16.7% vs.
Control
6.9%
(p=0.25).
Analysis of
those
treated:
Intervention
33.3% vs.
Control
6.9%
(p=0.05)
Table S4. Impact of cessation efforts on lung cancer surgical outcomes
Reference
Setup
Setting
Mason,
200912
Primary
resections
for lung
cancer
reported
to the
Society of
Thoracic
Surgeons
General
Thoracic
Surgery
Database.
Barrera,
200513,a
single
center;
academic
medical
center
Intervention
Study
design
(cited by
author or
actual)
Case-control
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
inclusion:
Age>18,
scheduled for
thoracotomy for
treatment of p
Neversmoker; quite
more than 12
mo. before
surgery; quit
1-12 mo.
before
surgery; quit
between than
14 days to 1
mo. before
surgery;
active smoker
Hospital
Mortality
Pulmonary
Complications
7990
Prospective
Cohort
Inclusion:
Age>18,
scheduled for
thoracotomy for
treatment of
primary or
secondary lung
tumor;
EXCLUSION second surgery
during same
hospitalization:
undergoing
concomitant rib,
chest wall,
diaphragmatic,
pericardial, or
pleural resection
Non-smokers,
past quitters
(>2 mo.
before
surgery);
recent
quitters (> 1
week & < 2
mo. before
surgery);
current
smoker
Respiratory
failure requiring
ICU admission
and/or
intubation;
pneumonia;
atelectasis
requiring
bronchoscopy;
PE;
supplemental
oxygen at
discharge
300
Numbers
51 (17%)
total postoperative
pulmonar
complicat
Nakagawa,
200114,b
single
center;
academic
medical
center
Retrospective
cohort
No specific
inclusion or
exclusion
criteria stated
Never
smokers;
recentsmoker
(smoke free
2-4 weeks
before
surgery); exsmoker
(smoke free >
4 weeks);
current
smokers
(smoked
within 2
weeks of
surgery)
Post-operative
complication
defined as one
or more of the
following (1)
atelectasis
prompting
bronchoscopy;
(2) pneumonia
defined by
radiographic
infiltrates plus
at least two of
the following:
temperature
37.7°C, WBC
count 10,500/
L, initiation of
antibiotic
therapy, and/or
demonstration
of pathogenic
organisms; (3)
Paco2 50 mm
Hg at 24 h after
the surgery; (4)
air leak or
effusion
requiring
intercostal tube
drainage for 7
days; (5)
bronchopleural
fistula with
large air leak or
infection; (6)
empyema; (7)
chylothorax; (8)
hemothorax
requiring
drainage or
reoperation; (9)
tension
pneumothorax;
(10) pulmonary
embolism; (11)
lobar gangrene;
(12)
mechanical
ventilation 72
h for any
reason; (13)
intercostal tube
drainage 14
days for any
reason; (14)
required
fraction of
inspired oxygen
0.6 or alveolararterial oxygen
gradient 300
mm Hg 24-h
postoperatively.
288
PPCs
occurred
43.2%,
53.8%,
34.7%, an
23.9% of
current,
recent, ex
smokers,
neversmokers,
respective
Groth,
200915,c
single
center;
academic
medical
center
Case series
NSCLC patients
undergoing
resection
between April
2000 and April
2006.
None
Length of stay
Rates of
postoperative
complications
213
Vaporciyan,
200216,d
single
center;
academic
medical
center
Case series
All patients who
underwent
pneumonectomy
between 1990
and 1999.
None
Rate of
postoperative
Major
Pulmonary
Events (MPE)
- defined as
either
pneumonia or
acute
respiratory
distress
syndrome.
Mortality,
Length of
stay, and
hospital
charges.
261
aSmall
study given the 4 levels of smoking status of interest - Type II error possible.
subjects in recent smoker group (n=13).
cSmall sample size per group. Type II error possible.
dPotential confounding by several important disease outcome modifiers.
bFew
Length of
stay
averaged
16, and 8
days for
current,
recent, an
distant
smokers,
respective
PPCs
occurred
44%, 18.8
and 42.7%
current,
recent, an
distant
smokers,
respective
34
nonsmoke
and 223
smokers.
14.7 and
12.6% MP
respective
Table S5. Impact of counseling interventions on smoking cessation rates.
Reference
Setup
Setting
Intervention
Study
design
(cited by
author or
actual)
RCT
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
Numbers
Cancer
patients
admitted to the
surgical ward,
undergoing
surgery with
an anticipated
length of stay
>3 days;
Current
smokers; >10
cigs per day.
Nurse delivered
smoking
cessation
intervention
during the
postoperative
period,
consisting of 3
consecutive
daily visits and
5 postdischarge
phone visits
Biochemically
verified
smoking status
5 weeks after
discharge.
N/A
26
12 patients
randomized to
experimental
condition, 14
to usual care
362
19% of
patients never
quit prior to
surgery. 16%
quit for <2
weeks prior to
surgery. 42%
had quit for
>1yr prior to
their surgery
date.
Stanislaw,
199417
94-bed
smokefree
cancer
hospital
.
Dresler,
199618
University
hospital
Case series
Patients who
underwent
thoracotomy
for resection of
lung
carcinoma.
Physician
advice to quit
Chart record of
smoking status
postoperatively
Wewers,
199719
University
hospital
Case series
Adult smokers
with suspected
diagnosis of
lung
carcinoma,
admitted to an
inpatient
thoracic
surgery unit for
diagnostic
testing
Nursemanaged
cessation
intervention
during
hospitalization
followed by a
clinic visit
follow-up 6
weeks post
discharge.
Biochemically
confirmed 7day point
prevalence
abstinence at
6 weeks after
discharge.
Intention to
quit
15
87% reported
an intent to
quit smoking
within the
month. 93%
reported at
least one quit
attempt at the
6 week follow
up visit. 40%
with confirmed
7-day point
prevalence
abstinence at
6 weeks.
Browning,
200020
University
hospital
surgery
clinic
Quasiexperimental
case series
Adult, daily
smokers for
one year or
longer,
confirmed
diagnosis of
surgically
managed nonsmall cell lung
cancer.
Nurse delivered ,
AHCPR-based
(5A) cessation
intervention
that included
face-to-face
and phone
follow-up
contact
beginning with
the first
preoperative
Biochemically
confirmed
smoking status
six months
post surgery
N/A
25
14 patients
assigned to
intervention
group, 11 to
usual care
clinic
consultation.
Griebel,
199821
University
hospital
RCT
Current
smokers or
recently
stopped
smoking;
Admitted with
a diagnosis of
cancer and
undergoing a
surgical
procedure, at
least 19 years
old.
One-time 20minute
cessation
intervention
during
postoperative
recovery
period plus
written
materials plus
5 weekly 10minute
telephone
counseling
sessions
Biochemically
confirmed 7day point
prevalence
abstinence at
6 weeks after
discharge.
Number of
cigarettes
smoked per
day
28
14 patients
randomized to
both the
intervention
and usual care
arms
Wewers,
199422
University
hospital
Prospective,
experimental,
random
assignment
Postoperative
smokers from
cardiovascular,
oncology, and
general
surgical units
Three
structured
smoking
cessation
sessions
during
hospitalization,
followed by
phone calls
once a week
for 5 weeks
after
discharge.
Self-reported
smoking
status,
confirmed by
salivary
cotinine, 5-6
weeks after
discharge.
Effect of
type of
surgery on
selfreported
smoking
status
80
Abstinence:
Control 25.6%
vs.
Intervention
37.8%
(p<0.10). Of
experimental
group patients:
Cardiovascular
40% vs.
Oncology
64.3% vs.
General
Surgery
13.3%.
Table S6. Impact of medication-based interventions on smoking cessation rates.
Reference
Setup
Setting
Intervention
Study
design
(cited by
author or
actual)
RCT
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
Numbers
Female daily
smokers, age
18 or above,
without alcohol
abuse, drug
abuse,
psychiatric comorbidities,
penetrating
cancer,
pregnancy, or
preoperative
neoadjuvant
chemotherapy.
One 45-90
minute
counseling
session, 3-7
days prior to
surgery. NRT
provided free.
Control group
received
routine
preoperative
information
Postoperative
complications
Perioperative
cessation
rates, 12
month
cessation
rates
120
58
Intervention,
62 Control
Thomsen,
201023
Tertiary
medical
centers three breast
surgical
departments
Thomsen,
200924
Tertiary
medical
centers three breast
surgical
departments
Qualitative
analysis
Female daily
smokers
presenting
with newly
diagnosed
breast cancer
One 45-90
minute
counseling
session, 3-7
days prior to
surgery. NRT
provided free.
Control group
received
routine
preoperative
information
Hermaneutical
analysis of the
experience of
preoperative
smoking
cessation
advice
N/A
11
April 2006 December
2007
Kozower,
201025
Single
institution
thoracic
surgery
clinic
Case series
Adults, smoke
more than 5
cigarettes per
week, and in
contemplation
/ preparation /
or action stage
of change.
10 minute
counseling
session plus
offer NRT
plus written
materials plus
referral to
quitline. No
comparator
group
7-day point
prevalence
abstinence at
3 months
Factor
analysis of
variable
associated
with
cessation
60
N/A
Park,
201126
University
hospital
oncology
clinic
Nonrandomized,
open-label,
pre-post
design
Suspected
diagnosis of
thoracic
cancer,
smoked at
least one
cigarette in
past two
weeks, no
metastatic
disease at
presentation,
considered
medically
eligible by
thoracic
surgeon and
oncologist.
12 weeks
varenicline
plus 7 weekly
counseling
sessions
Biochemically
confirmed 7day point
prevalence
abstinence at
12 weeks
Biochemically
confirmed 7day point
prevalence
abstinence at
2 weeks
49
32 assigned
to
intervention
group, 14 to
control
Table S7. Impact of counseling interventions on smoking cessation rates
Reference
Setup
Setting
Intervention
Study
design
(cited by
author or
actual)
RCT
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
Numbers
S
d
Cancer
diagnosis,
smoke more
than once
weekly,
prognosis > 6
months
.
Intervention:
Telephone +
in-person
counseling
using
Motivational
Interviewing
technique.
NRT offered
to participants
using >15
cigarettes
daily.
Control: Brief
advice to quit
+ written
materials
Biochemically
confirmed 7day point
prevalence
abstinence at
3 month
follow-up
Quit attempts
137
63 subjects
randomized
to control
condition,
74 to
intervention
M
to
D
2
Predictors of
abstinence at
1 and 3
months
109
57 subjects
randomized
to control
condition,
52 to
intervention
"
m
Wakefield,
200427
Tertiary
Care
Hospital
Schnoll,
200528
Tertiary
Care
Hospital
RCT
Head and
Neck cancer
diagnosis,
active
smoking
within prior 30
days
Intervention:
Counseling
using the
CognitiveSocial Health
InformationProcessing
model.
Control:
standard
general
health
information
approach to
cessation
Self-reported
30-day
continuous
abstinence at
1 and 3
months
de BruinVisser,
201129
10 hospitalbased
medical
and dental
clinics in
southern
California
Case
Series
Head and
Neck cancer
diagnosis,
Lung cancer
diagnosis,
active smoker
Behavioral
counseling
based on
Bandura's
self-efficacy
model and
Prochaska's
stage of
Self-reported
abstinence at
6 and 12
months
145
N
2
D
2
change
model.
Gritz,
199330
10 hospitalbased
medical
and dental
clinics in
southern
California
RCT
Newly
diagnosed,
first primary
carcinoma of
the oral
cavity,
pharynx,
larynx.
Tobacco use
within the
prior year.
Usual care:
Strong advice
to stop plus
written
materials.
Intervention:
7 regular
counseling
visits, target
quit date, quit
contract.
Biochemically
conformed
cessation
rates at 1
month
Biochemically
conformed
cessation
rates at 6
and 12
months
186
114
subjects
completed
the trial, 72
were
withdrawn
for various
reasons.
Table S8. Impact of medication-based interventions on smoking cessation
Reference
Setup
Setting
Intervention
Study
design
(cited by
author or
actual)
RCT
Eligibility
criteria
Interventions
Primary
outcome
measure
Head/Neck
cancer;
screened
positive for
smoking,
alcohol
dependence,
depression;
not pregnant;
>18 years old
.
All patients
received 45minute nursing
assessment.
Those
randomized to
intervention also
received a CBT
workbook, 9 to
11 sessions of
CBT telephone
counseling, and
pharmacologic
management
Continuous
abstinence
from smoking
for 6 months.
Secondary
outcome
measure(s)
Sample
size
Numbers
St
du
184
91
randomized
to usual
care, 93 to
intensive
intervention
20
20
Duffy,
200631
Four
hospitals,
University
cancer
center
Cox,
200232
Tertiary
care center
Casematched
casecontrol
Patients in
the nicotine
dependence
clinic
database
Nicotine
dependence
treatment
includes
aggressive CBT
and
pharmacotherapy
support
6-month selfreported point
prevalence
tobacco use
status
N/A
402
201 cases
with dateoftreatment
matched
controls
D
av
fro
on
Garces,
200433
Tertiary
care center
Casematched
casecontrol
Patients in
the nicotine
dependence
clinic
database
Nicotine
dependence
treatment
includes
aggressive CBT
and
pharmacotherapy
support
6-month selfreported point
prevalence
tobacco use
status
N/A
202
101 cases
with dateoftreatment
matched
controls
Ap
-J
20
Schnoll,
200334
Eastern
Cooperative
Oncology
Group
member
institutions
RCT
19 years old
or older,
diagnosed
with stage I-II
cancer of any
type, stage
III-IV breast,
prostate,
Intervention:
Physician
counseling based
on 5As + NRT =+
Self help
materials +
Quitline referral.
Control: Usual
Telephone
assessment
of smoking
status at 6
and 12
months.
Physician
adherence
to protocol
432
217
patients
assigned to
usual care,
215 to
physicianbased
intervention
D
19
Ju
Schnoll,
201035
Tertiary
care center
RCT
testicular
cancer or
lymphoma,
performance
status 0-1.
care (Brief advice
+ Quitline
referral)
18 years old
or over, at
least 2
cigarettes
daily,
possess a
telephone,
have a
cancer
diagnosis.
All received 5
counseling
sessions and 8
weeks of NRT.
Randomized to
active bupropion
or placebo.
Biochemically
confirmed
treatment
effects of
bupropion (7day point
prevalence
abstinence)
at 12 and 27
weeks;
interaction
with baseline
depression
symptoms.
QOL, and
effect of
depression
on
abstinence
246
Of the 132
subjects
randomized
to placebo,
27 had
depression
symptoms
at baseline.
Of the 114
subjects
randomized
to active
treatment,
28 had
depression
symptoms
O
20
Ap
Table S9. Impact of smoking cessation on radiation therapy.
Reference
Setup
Setting
Zevallos,
200936
University
hospital
Study
design
(cited by
author or
actual)
Prospective
cohort
Semrau,
2008
University
hospital
Casecontrol
Intervention
Eligibility
criteria
Interventions
Primary
outcome
measure
Secondary
outcome
measure(s)
Sample
size
Numbers
All smokers
with head
and neck
cancer who
were new to
the institution
Counseling
and
pharmacologic
management
XRT
complication
rates
Effect of
tobacco use
treatment
on
complication
rates
81
37
abstainers,
and 44
nonabstainers
identified
Stage I to
IIIB NSCLC,
inoperable
due to
medical
comorbidities
N/A
Associations
between
comorbidities
and XRT
outcome
N/A
66
References
1. Styn MA, Land SR, Perkins KA, Wilson DO, Romkes M, Weissfeld JL. Smoking behavior 1 year
after computed tomography screening for lung cancer: Effect of physician referral for abnormal CT
findings. Cancer Epidemiol, Biomarkers Prev. 2009;18(2)L3484-3489.
2. Anderson CM, Yip R, Henschke CI, Yankelvitz, DF, Ostroff JS, Burns DM. Smoking
cessation and relapse during a lung cancer screening program. Cancer Epidemiol,
Biomarkers Prev. 2009;18(12):3476-3483.
3. Coz LS, Clark MM, Jett JR, Patten CA, Schroeder DR, Nirelli LM, Swensen SJ, Hurt RD.
Change in smoking status after spiral chest computed tomography scan screening.
Cancer. 98(11):2495-2501.
4. MacRedmond R, McVey G, Lee M, Costello RW, Kenny D, Foley C, Logan PM, on
behalf of the PALCD Investigators. Screening for lung cancer using low dose CT scanning:
results of 2 year follow up. Thorax. 2006;61:54-56.
5. Schnoll RA, Miller SM, Unger M, McAleer C, Halbherr T, Bradley P. Characteristics of
female smokers attending a lung cancer screening program: a pilot study with
implications for program development. Lung Cancer. 2002;37(3):257-265.
6. Clark MM, Cox LS, Jett JR, Patten CA, Schroeder DR, Nirelli LM et al. Effectiveness of
smoking cessation self-help materials in a lung cancer screening population. Lung
Cancer 2004;44(1):13-21.
Study
duration
Novemb
1998 to
June
2005
7. Ashraf H, Tonnesen P, Pedersen JH, Dirksen A, Thorsen H, Dossing M. Effect of CT
screening on smoking habits at 1-year follow-up in the Danish Lung Cancer Screening
Trial (DLCST). Thorax 2009; 64:388-392.
8. Aalst CM, Bergh KAM, Willemsen MC, Koning HJ, Klaveren RJ. Lung cancer
screening and smoking abstinence: 2 year follow-up data from the Dutch-Belgian
randomised controlled lung cancer screenign trial. Thorax. 2010;65:600-605.
9. Parkes G, Greenhalgh T, Griffin M, Dent R. Effect on smoking quit rate of telling
patients their lung age: the Step2quit randomised controlled trial. BMJ.
2008;336(7644):598-600.
10. Anthonisen N, Skeans M, Wise R, Manfreda J, Kanner R, Connett J for the Lung
Health Study Research Group. The effects of a smoking cessation intervention on 14.5year mortality. Ann Intern Med. 142:233-239..
11. Osinubi OY, Moline J, Rovner E, Sinha S, Perez-Lugo M, Demissie K, Kipen HM. A pilot
study of telephone-based smoking cessation intervention in asbestos workers. J Occup
Environ Med. 2003;45(5):569-574.
12. Mason DP, Subramanian S, Nowicki ER, Grab JD, Murthy SC, Rice TW, Blackstone
EH. Impact of smoking cessation before resection of lung cancer: a Society of Thoracic
Surgeons General Thoracic Surgery Database study. Annals Thoracic Surgery.
2009;88(2):362-70.
13. Barrera R, Shi W, Amar D, Thaler HT, Gabovich N, Bains MS, White DA. Smoking
and Timing of Cessation: Impact on Pulmonary Complications After Thoracotomy. Chest.
2005;127;1977-1983.
14. Nakagawa M, Tanaka H, Tsukuma H, Kishi Y. Relationship Between the Duration of
Preoperative Smoke-Free Period and the Incidence of Postoperative Pulmonary
Complications After Pulmonary Surgery. Chest. 2001;120:705-710.
15. Groth SS, Whitson BA, Kuskowski MA, Holmstrom AM, Rubins JB, Kelly RF. Impact of
preoperative smoking status on postoperative complication rates and pulmonary
function test results 1-year following pulmonary resection for non-small cell lung cancer.
Lung Cancer. 2009;64(3):352-357.
16. Vaporciyan AA, Merriman KW, Ece F, Roth JA, Smythe WR, Swisher SG, Walsh GL,
Nesbitt JC, Putnam JB. Incidence of major pulmonary morbidity after pneumonectomy:
association with timing of smoking cessation. Ann Thorac Surg. 2002;73(2):420-425.
17. Stanislaw AE, Wewers ME. A smoking cessation intervention with hospitalized
surgical cancer patients: a pilot study. Cancer Nurs. 1994;17(2):81-86.
18. Dresler CM. Bailey M. Roper CR. Patterson GA. Cooper JD. Smoking cessation and
lung cancer resection. Chest. 1996;110(5):1199-1202.
19. Wewers ME, Jenkins L, Mignery T. A nurse-managed smoking cessation
intervention during diagnostic testing for lung cancer. Oncology Nursing Forum.
1997;24(8):1419-1422.
20. Browning KK, Ahijevych KL, Ross P Jr, Wewers ME. Implementing the Agency for
Health Care Policy and Research's Smoking Cessation Guideline in a lung cancer surgery
clinic. Oncology Nursing Forum. 2000;27(8):1248-1254.
21. Griebel B, Wewers ME, Baker CA. The effectiveness of a nurse-managed minimal
smoking-cessation intervention among hospitalized patients with cancer. Oncol Nurs
Forum. 1998;25(5):897-902.
22. Wewers ME. Bowen JM. Stanislaw AE. Desimone VB. A nurse-delivered smoking
cessation intervention among hospitalized postoperative patients--influence of a
smoking-related diagnosis: a pilot study. Heart Lung. 1994;23(2):151-156.
23. Thomsen T, Tonnesen H, Okholm M, Kroman N, Maibom A, Sauerberg ML, Moller
AM. Brief smoking cessation intervention in relation to breast cancer surgery: a
randomized controlled trial. Nicotine Tobacco Research. 2010;12(11):1118-1124.
24. Thomsen T, Esbensen BA, Samuelsen S, Tonnesen H, Moller AM. Brief
preoperative smoking cessation counseling in relation to breast cancer surgery: a
qualitative study. Eur J Oncol Nursing. 2009;13(5):344-349.
25. Kozower BD. Lau CL. Phillips JV. Burks SG. Jones DR. Stukenborg GJ. A thoracic
surgeon-directed tobacco cessation intervention. Annals Thoracic Surgery.
2010;89(3):926-930.
26. Park ER, Japuntich S, Temel J, Lanuti M, Pandiscio J, Hilgenberg J, Davies D, Dresler C,
Rigotti NA. A smoking cessation intervention for thoracic surgery and oncology clinics: a
pilot trial. J Thorac Oncol. 2011; 6(8):1454.
27. Wakefield M, Olver I, Whitford H, Rosenfeld E. Motivational interviewing as a
smoking cessation intervention for patients with cancer: randomized controlled trial.
Nursing Research. 2004;53(6):396-405.
28. Schnoll RA, Rothman RL, Wielt DB, Lerman C, Pedri H, Wang H et al. A randomized
pilot study of cognitive-behavioral therapy versus basic health education for smoking
cessation among cancer patients. Ann Behav Med. 2005; 30(1):1-11.
29. de Bruin-Visser JC, Ackerstaff AH, Rehorst H, Retèl VP, Hilgers FJ. Integration of a
smoking cessation program in the treatment protocol for patients with head and neck
and lung cancer. Eur Arch Otorhinolaryngol. 2011; Jun 23. [Epub ahead of print]
30. Gritz ER, Carr CR, Rapkin D, Abemayor E, Chang LJ, Wong WK, Belin TR, Calcaterra T,
Robbins KT, Chonkich G, et al. Predictors of long-term smoking cessation in head and
neck cancer patients. Cancer Epidemiol Biomarkers Prev. 1993 May-Jun;2(3):261-70.
31. Duffy SA, Ronis DL, Valenstein M, Lambert MT, Fowler KE, Gregory L et al. A tailored
smoking, alcohol, and depression intervention for head and neck cancer patients.
Cancer Epidemiol Biomarkers Prev. 2006;15(11):2203-2208.
32. Cox LS, Patten CA, Ebbert JO, Drews AA, Croghan GA, Clark MM et al. Tobacco use
outcomes among patients with lung cancer treated for nicotine dependence. J Clinical
Oncol. 2002;20(16):3461-3469.
33. Garces YI, Schroeder DR, Nirelli LM, Croghan GA, Croghan IT. Foote RL. Hurt RD.
Tobacco use outcomes among patients with head and neck carcinoma treated for
nicotine dependence: a matched-pair analysis. Cancer. 2004;101(1):116-124.
34. Schnoll RA, Zhang B, Rue M, Krook JE, Spears WT, Marcus AC, Engstrom PF. Brief
physician-initiated quit-smoking strategies for clinical oncology settings: a trial
coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol. 2003 Jan
15;21(2):355-65.
35. Schnoll RA, Martinez E, Tatum KL, Weber DM, Kuzla N, Glass M et al. A bupropion
smoking cessation clinical trial for cancer patients. Cancer Causes Control. 2010;
21(6):811-820.
36. Zevallos JP, Mallen M, Lam CY, Karam-Hage M, Blalock J, Wetter DW et al.
Complications of radiotherapy in laryngopharyngeal cancer: effects of a prospective
smoking cessation program. Cancer. 2009;115(19):4636-4644.
37. Semrau S, Klautke G, Virchow JC, Kundt G, Fietkau R. Impact of comorbidity and
age on the outcome of patients with inoperable NSCLC treated with concurrent
chemoradiotherapy. Respiratory Medicine. 2008;102(2):210-218.