Does free nicotine replacement improve smoking cessation rates in cancer patients?

  • A. J Arifin London Regional Cancer Program
  • L. C. McCracken London Regional Cancer Program
  • S. Nesbitt London Regional Cancer Program
  • A. Warner London Regional Cancer Program
  • R. E. Dinniwell London Regional Cancer Program
  • D. A. Palma London Regional Cancer Program
  • A. V. Louie Sunnybrook Health Sciences Centre
Keywords: Nicotine replacement therapy, smoking cessation

Abstract

Background Cigarette smoking is carcinogenic and has been linked to inferior treatment outcomes and complication rates in cancer patients. Here, we report the results of an 18-month pilot smoking cessation program that provided free nicotine replacement therapy (nrt).

Methods In January 2017, the smoking cessation program at our institution began offering free nrt for actively cigarette-smoking patients with cancer. The cost of 4 weeks of nrt was covered by the program, and follow-up was provided by smoking cessation champions.

Results From January 2017 to June 2018, 8095 patients with cancer were screened for cigarette use, of whom 1135 self-identified as current or recent smokers. Of those 1135 patients, 117 enrolled in the program and accepted a prescription for nrt. The rates of patient referral and patients attending a referral appointment were significantly higher in 2018–2018 than they had been in 2015–2016 (100% vs. 80.3%, p < 0.001, and 27.6% vs. 11.3%, p < 0.001, respectively). Median follow-up was 9.0 months (25%–75% interquartile range: 5.7–11.6 months). Of the patients who accepted nrt and who also had complete data (n = 71), 25 (35.2%) reported complete smoking cessation, and 32 (45.1%) reported only decreased cigarette smoking. On univariable analysis, no factors were significantly predictive of smoking cessation, although initial cigarette use (>10 vs. ≤10 initial cigarettes) was significantly predictive of smoking reduction (odds ratio: 5.04; 95% confidence interval: 1.46 to 17.45; p = 0.011).

Conclusions This pilot study of free nrt demonstrated rates of referral and acceptance of nrt that were improved compared with historical rates, and most referred patients either decreased their use of cigarettes or quit entirely.

Author Biographies

A. J Arifin, London Regional Cancer Program
Division of Radiation Oncology
L. C. McCracken, London Regional Cancer Program
Division of Radiation Oncology
S. Nesbitt, London Regional Cancer Program

Division of Radiation Oncology

A. Warner, London Regional Cancer Program

Division of Radiation Oncology

R. E. Dinniwell, London Regional Cancer Program

Division of Radiation Oncology

D. A. Palma, London Regional Cancer Program

Division of Radiation Oncology

A. V. Louie, Sunnybrook Health Sciences Centre

Department of Radiation Oncology

Published
2020-03-06
How to Cite
Arifin, A. J., McCracken, L. C., Nesbitt, S., Warner, A., Dinniwell, R. E., Palma, D. A., & Louie, A. V. (2020). Does free nicotine replacement improve smoking cessation rates in cancer patients?. Current Oncology, 27(1). https://doi.org/10.3747/co.27.5267
Section
Cancer Control and Prevention