Efficacy of a tobacco quitline among adult survivors of childhood cancer

Nicotine Tob Res. 2015 Jun;17(6):710-8. doi: 10.1093/ntr/ntu216. Epub 2014 Oct 21.


Introduction: The purpose of this investigation was to determine the efficacy of two evidence-based tobacco quitlines in adult survivors of childhood cancer who regularly smoke cigarettes.

Methods: A total of 519 adult survivors of childhood cancer were randomized to either Proactive + 4 weeks of medication (Counselor-initiated intervention, n = 260) or a Reactive + 2 weeks of medication (Participant-initiated intervention, n = 259) condition. Both conditions received telephone counseling to quit smoking as well as nicotine replacement therapy. The primary outcome was biochemically verified (i.e. cotinine) point prevalence smoking cessation at 12 months follow-up.

Results: Participants randomized to the Proactive + 4 weeks of medication condition self-reported a higher rate of cessation than those survivors in the Reactive + 2 weeks of medication condition at 8 weeks (33.2% vs. 17.0%, p < .001), but cessation rates were not significantly different at 12 months (23.0% vs. 18.7%, p = .29). However, 80% of participants claiming abstinence failed biochemical verification, indicating marked falsification of self-reported smoking status. Adjusted cessation rates were less than 2% in both intervention conditions.

Conclusions: Our results indicate that neither a Proactive + 4 weeks of medication or Reactive + 2 weeks of medication quitline significantly impacted long-term smoking cessation rates. Our results further indicate that self-reports of smoking status are unreliable in survivors of childhood cancer, a population in considerable need of tobacco abstinence. Rates of smoking cessation may be markedly overestimated in studies of childhood cancer survivors that rely on self-reports of tobacco abstinence, and future studies need to include biochemical verification of tobacco status in this population.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cotinine
  • Counseling / methods*
  • Female
  • Hotlines*
  • Humans
  • Male
  • Neoplasms*
  • Nicotiana
  • Prevalence
  • Smoking / epidemiology
  • Smoking / therapy*
  • Smoking Cessation / methods*
  • Survivors*
  • Telephone
  • Tobacco Products
  • Tobacco Use Cessation Devices*
  • Tobacco Use Disorder / therapy*
  • Treatment Outcome


  • Cotinine