Early Treatment Engagement and Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia or Cervical Cancer

Charles E. Hoogland; Steven K. Sutton; Bethany Shorey Fennell; Vani N. Simmons; Christine Vinci; Issam El Naqa; Ramzi G. Salloum; Sanjay S. Shete; Timothy Hembree; Damon J. Vidrine; Jennifer I. Vidrine

doi:10.1016/j.focus.2025.100361

Early Treatment Engagement and Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia or Cervical Cancer

Charles E. Hoogland
, Steven K. Sutton
, Bethany Shorey Fennell
, Vani N. Simmons
, Christine Vinci
, Issam El Naqa
, Ramzi G. Salloum
, Sanjay S. Shete
, Timothy Hembree
, Damon J. Vidrine
, Jennifer I. Vidrine

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Introduction: Cancer survivors who quit smoking have improved treatment response and decreased mortality. Although data indicate that greater tobacco cessation treatment engagement leads to better cessation outcomes in cancer survivors, little is known about how different tobacco treatment engagement patterns influence long-term cessation success. To help address this issue, this study examined how tobacco treatment engagement patterns predict cessation outcomes through 18 months and identified baseline participant characteristics predictive of treatment engagement patterns. Methods: Data from a smoking-cessation RCT among women with a history of cervical intraepithelial neoplasia or cervical cancer comparing a 12-month, 6-session motivation and problem solving phone counseling intervention with standard treatment (tobacco quitline referrals) were analyzed. Treatment was completed remotely through self-administered nicotine replacement therapy and telephone counseling. Participants (n=202) were recruited in clinic in Oklahoma City and online nationally and randomly assigned to motivation and problem solving or standard treatment. Data from all 98 participants in motivation and problem solving alive at 18 months were included in the analyses. Results: Controlling for baseline covariates, high total treatment engagement (i.e., completing ≥4 counseling sessions) predicted abstinence at 12 months (OR=11.37; 95% CI=2.34, 55.27; p=0.003) and 18 months (OR=12.71; 95% CI=1.42, 113.40; p=0.023). The best predictor of high total treatment engagement was high early treatment engagement (i.e., completing ≥3 counseling sessions within the first 3 months). Conclusions: Given that few tobacco treatment interventions have demonstrated efficacy among cancer survivors, the current findings suggest a need for careful monitoring of treatment engagement and the possibility of making changes to treatment plans when early engagement is poor.

Original language	English
Article number	100361
Journal	AJPM Focus
Volume	4
Issue number	4
DOIs	https://doi.org/10.1016/j.focus.2025.100361
State	Published - Aug 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s)

Funding

Funding: A National Cancer Institute grant (R01CA172786) awarded to JIV supported this work. Additional support was provided by the Biostatistics and Bioinformatics Shared Resource at the H. Lee Moffitt Cancer Center and Research Institute; a National Cancer Institute Designated Comprehensive Cancer Center (P30CA76292); and Cancer Center Support Grants for the University of Oklahoma’s Stephenson Cancer Center (P30CA225520), the University of Texas MD Anderson Cancer Center (P30CA016672), the University of Kentucky Markey Cancer Center (P30CA177558), and the UF Health Cancer Center (P30CA247796).

Funders	Funder number
Cancer Research Informatics, and Biostatistics and Bioinformatics Shared Resource Facilities
University of Texas Anderson Cancer Center	P30CA016672
National Childhood Cancer Registry – National Cancer Institute	R01CA172786, P30CA76292
University of Kentucky Markey Comprehensive Cancer Center	P30CA177558
Cancer Center, University of Florida Health	P30CA247796
Stephenson Cancer Center’s Cancer Center	P30CA225520

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

RCT
Smoking cessation
cancer
cancer survivors
cervical cancer
cervical intraepithelial neoplasia

ASJC Scopus subject areas

Epidemiology
Health Informatics
Public Health, Environmental and Occupational Health

Access to Document

10.1016/j.focus.2025.100361

Cite this

Hoogland, C. E., Sutton, S. K., Fennell, B. S., Simmons, V. N., Vinci, C., Naqa, I. E., Salloum, R. G., Shete, S. S., Hembree, T., Vidrine, D. J., & Vidrine, J. I. (2025). Early Treatment Engagement and Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia or Cervical Cancer. AJPM Focus, 4(4), Article 100361. https://doi.org/10.1016/j.focus.2025.100361

@article{d3a35feacd32423091774afaf524ec08,

title = "Early Treatment Engagement and Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia or Cervical Cancer",

abstract = "Introduction: Cancer survivors who quit smoking have improved treatment response and decreased mortality. Although data indicate that greater tobacco cessation treatment engagement leads to better cessation outcomes in cancer survivors, little is known about how different tobacco treatment engagement patterns influence long-term cessation success. To help address this issue, this study examined how tobacco treatment engagement patterns predict cessation outcomes through 18 months and identified baseline participant characteristics predictive of treatment engagement patterns. Methods: Data from a smoking-cessation RCT among women with a history of cervical intraepithelial neoplasia or cervical cancer comparing a 12-month, 6-session motivation and problem solving phone counseling intervention with standard treatment (tobacco quitline referrals) were analyzed. Treatment was completed remotely through self-administered nicotine replacement therapy and telephone counseling. Participants (n=202) were recruited in clinic in Oklahoma City and online nationally and randomly assigned to motivation and problem solving or standard treatment. Data from all 98 participants in motivation and problem solving alive at 18 months were included in the analyses. Results: Controlling for baseline covariates, high total treatment engagement (i.e., completing ≥4 counseling sessions) predicted abstinence at 12 months (OR=11.37; 95\% CI=2.34, 55.27; p=0.003) and 18 months (OR=12.71; 95\% CI=1.42, 113.40; p=0.023). The best predictor of high total treatment engagement was high early treatment engagement (i.e., completing ≥3 counseling sessions within the first 3 months). Conclusions: Given that few tobacco treatment interventions have demonstrated efficacy among cancer survivors, the current findings suggest a need for careful monitoring of treatment engagement and the possibility of making changes to treatment plans when early engagement is poor.",

keywords = "RCT, Smoking cessation, cancer, cancer survivors, cervical cancer, cervical intraepithelial neoplasia",

author = "Hoogland, \{Charles E.\} and Sutton, \{Steven K.\} and Fennell, \{Bethany Shorey\} and Simmons, \{Vani N.\} and Christine Vinci and Naqa, \{Issam El\} and Salloum, \{Ramzi G.\} and Shete, \{Sanjay S.\} and Timothy Hembree and Vidrine, \{Damon J.\} and Vidrine, \{Jennifer I.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s)",

year = "2025",

month = aug,

doi = "10.1016/j.focus.2025.100361",

language = "English",

volume = "4",

number = "4",

}

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T1 - Early Treatment Engagement and Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia or Cervical Cancer

AU - Hoogland, Charles E.

AU - Sutton, Steven K.

AU - Fennell, Bethany Shorey

AU - Simmons, Vani N.

AU - Vinci, Christine

AU - Naqa, Issam El

AU - Salloum, Ramzi G.

AU - Shete, Sanjay S.

AU - Hembree, Timothy

AU - Vidrine, Damon J.

AU - Vidrine, Jennifer I.

PY - 2025/8

Y1 - 2025/8

N2 - Introduction: Cancer survivors who quit smoking have improved treatment response and decreased mortality. Although data indicate that greater tobacco cessation treatment engagement leads to better cessation outcomes in cancer survivors, little is known about how different tobacco treatment engagement patterns influence long-term cessation success. To help address this issue, this study examined how tobacco treatment engagement patterns predict cessation outcomes through 18 months and identified baseline participant characteristics predictive of treatment engagement patterns. Methods: Data from a smoking-cessation RCT among women with a history of cervical intraepithelial neoplasia or cervical cancer comparing a 12-month, 6-session motivation and problem solving phone counseling intervention with standard treatment (tobacco quitline referrals) were analyzed. Treatment was completed remotely through self-administered nicotine replacement therapy and telephone counseling. Participants (n=202) were recruited in clinic in Oklahoma City and online nationally and randomly assigned to motivation and problem solving or standard treatment. Data from all 98 participants in motivation and problem solving alive at 18 months were included in the analyses. Results: Controlling for baseline covariates, high total treatment engagement (i.e., completing ≥4 counseling sessions) predicted abstinence at 12 months (OR=11.37; 95% CI=2.34, 55.27; p=0.003) and 18 months (OR=12.71; 95% CI=1.42, 113.40; p=0.023). The best predictor of high total treatment engagement was high early treatment engagement (i.e., completing ≥3 counseling sessions within the first 3 months). Conclusions: Given that few tobacco treatment interventions have demonstrated efficacy among cancer survivors, the current findings suggest a need for careful monitoring of treatment engagement and the possibility of making changes to treatment plans when early engagement is poor.

AB - Introduction: Cancer survivors who quit smoking have improved treatment response and decreased mortality. Although data indicate that greater tobacco cessation treatment engagement leads to better cessation outcomes in cancer survivors, little is known about how different tobacco treatment engagement patterns influence long-term cessation success. To help address this issue, this study examined how tobacco treatment engagement patterns predict cessation outcomes through 18 months and identified baseline participant characteristics predictive of treatment engagement patterns. Methods: Data from a smoking-cessation RCT among women with a history of cervical intraepithelial neoplasia or cervical cancer comparing a 12-month, 6-session motivation and problem solving phone counseling intervention with standard treatment (tobacco quitline referrals) were analyzed. Treatment was completed remotely through self-administered nicotine replacement therapy and telephone counseling. Participants (n=202) were recruited in clinic in Oklahoma City and online nationally and randomly assigned to motivation and problem solving or standard treatment. Data from all 98 participants in motivation and problem solving alive at 18 months were included in the analyses. Results: Controlling for baseline covariates, high total treatment engagement (i.e., completing ≥4 counseling sessions) predicted abstinence at 12 months (OR=11.37; 95% CI=2.34, 55.27; p=0.003) and 18 months (OR=12.71; 95% CI=1.42, 113.40; p=0.023). The best predictor of high total treatment engagement was high early treatment engagement (i.e., completing ≥3 counseling sessions within the first 3 months). Conclusions: Given that few tobacco treatment interventions have demonstrated efficacy among cancer survivors, the current findings suggest a need for careful monitoring of treatment engagement and the possibility of making changes to treatment plans when early engagement is poor.

KW - RCT

KW - Smoking cessation

KW - cancer

KW - cancer survivors

KW - cervical cancer

KW - cervical intraepithelial neoplasia

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UR - https://www.scopus.com/pages/publications/105008768095#tab=citedBy

U2 - 10.1016/j.focus.2025.100361

DO - 10.1016/j.focus.2025.100361

M3 - Article

AN - SCOPUS:105008768095

SN - 2773-0654

VL - 4

JO - AJPM Focus

JF - AJPM Focus

IS - 4

M1 - 100361

ER -

Early Treatment Engagement and Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia or Cervical Cancer

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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Cite this