The novel Motivation And Problem Solving (MAPS) treatment produced a 2-fold increase in smoking abstinence among survivors of cervical intraepithelial neoplasia (CIN) or cervical cancer at 12 months, but the effect disappeared by 18 months, a study shows.
Participants were adult women with histories of CIN or cervical cancer and who reported current smoking (≥100 lifetime cigarettes plus any smoking in the past 30 days). Random assignment to standard treatment (ST; repeated referrals to a tobacco cessation quitline, self-help materials, and combination patch plus lozenge nicotine replacement therapy) or MAPS (all ST interventions plus 6 proactive telephone counseling sessions over 12 months) produced these results based on a primary outcome of self-reported 7-day point prevalence abstinence from tobacco at 18 months: “There was no significant effect for MAPS over ST at 18 months (14.2% v 12.9%, P = .79). However, there was a significant condition × assessment interaction (P= .015). Follow-up analyses found that MAPS (v ST) abstinence rates were significantly greater at 12 months (26.4% v 11.9%, P = .017; estimated OR, 2.60; 95% CI, 1.19 to 5.89).”
Editorial: “To achieve optimal and equitable implementation of cessation services, not only must interventions be driven by evidence, but services must also be delivered with a thorough understanding of the persistent stigma and biases experienced by individuals who continue to smoke or use tobacco after a cancer diagnosis,” editorialists write. “By implementing empathic communication strategies regarding the assessment of tobacco use and cessation opportunities, not only can cancer care clinicians increase the likelihood of improving cessation and cancer outcomes, but also services and support can be delivered in a manner that enhances the clinician-patient relationship.”