Efficacy of Smoking Cessation Intervention for Head and Neck Cancer Patients

Smoking Cessation Intervention for Head and Neck Cancer Patients: A Prospective Randomised Controlled Trial

The purpose of this study is to determine whether a brief smoking ENT-resident-based intervention increased smoking cessation in patients with Head and Neck cancer attending a Lebanese university hospital, as compared with usual care.

The primary objective of the study is to evaluate the effectiveness of a brief smoking physician-based intervention on smoking-cessation rates in Head and Neck cancer adult patients. The secondary objective is to assess predictors of long-term smoking cessation in such patients.

After an initial assessment of demographic, clinical and smoking characteristics, the patients are randomised (based on a computer randomisation program) in 2 groups:

• Group 1 will receive the usual care in Lebanon, which consists of a brief advice to quit (10 seconds)
• Group 2 will receive a brief (10-15 minutes) standardised smoking cessation counseling session peri-operatively (immediately before or after surgery), by an ENT residents, based on the 5 "A"'s motivational interviewing model:
• Ask (screen for tobacco use)
• Advise (provide a personalised and strong quit message)
• Assess (evaluate the smoker's willingness and readiness to quit)
• Assist (provide cessation counseling, pharmacotherapy, self-help guides)
• Arrange (for followup to prevent relapse, and evaluate cessation progress) A motivational gadget will be distributed to group 2 patients. They will also be offered nicotine replacement therapy (nicotine transdermal patches) for a total of 8 weeks. This will be followed by a telephone boost session after 6 weeks.

The follow-up at 3, 6 and 12 months will be done, for the 2 groups, by a person not implicated in either the randomisation or the intervention (single-blind), in person or, if impossible, by telephone.

Inclusion Criteria:

• Head and Neck cancer
• Patients hospitalised from biopsy or surgery
• Current smokers = smokers in the past 3 months
• Reachable by phone

Exclusion Criteria:

• Nonsmokers in the past 3 months
• Current drug dependance
• Pregnant women
• Psychiatric conditions
• Patients under current smoking cessation intervention