The gold standard program (GSP) for smoking cessation: a cohort study of its effectiveness among smokers with and without cancer

Abstract

Background

Smoking cessation treatment is an important prognostic factor for survival after a cancer diagnosis, especially for tobacco-related cancers. After being diagnosed with lung cancer, approximately 50% of patients continue smoking or frequently relapse after a quit attempt. Given the importance of smoking cessation treatment for cancer survivors, the objective was to compare the effectiveness of a 6-week intensive smoking cessation intervention, the Gold Standard Program (GSP), among cancer survivors compared with smokers without cancer. Second, we compared successful quitting among socioeconomically disadvantaged cancer survivors with that among nondisadvantaged cancer survivors.

Materials and Methods

This was a cohort study based on 38,345 smokers from the Danish Smoking Cessation Database (2006–2016). Linkage to the National Patient Register was used to identify cancer survivors undergoing the GSP after being diagnosed with cancer (except nonmelanoma skin cancer). Linkage to the Danish Civil Registration System was used to identify participants who died, went missing, or emigrated before the follow-up. Logistic regression models were applied to evaluate effectiveness.

Results and Conclusion

Six percent (2438) of the included smokers were cancer survivors at the time they undertook the GSP. Their 6-month successful quitting showed no difference compared to that of smokers without cancer, neither before nor after adjustment; 35% versus 37% in crude rates and an aOR of 1.13 (95% CI: 0.97–1.32). Likewise, the results for disadvantaged compared to nondisadvantaged cancer survivors were not significantly different (32% versus 33% and an adjusted aOR of 0.87 (95% CI 0.69–1.11)). Overall, an intensive smoking cessation program seems effective in helping both people without cancer and cancer survivors become successful quitters.

Keywords:

• Intensive smoking cessation intervention
• cancer
• disadvantaged smokers

Acknowledgements

All smokers are acknowledged for agreeing to be registered in the Smoking Cessation Database, as are all staff at the participating Smoking Cessation Clinics and the staff at the National Secretariat. The Danish Ministry of Health, the Danish Health Authority, and Bispebjerg and Frederiksberg Hospital are acknowledged for financing the Danish Smoking Cessation Database.

Ethical approval

This project was approved by the Danish Data Protection Agency (#2014-41-3370/2010-41-5463/2000-54-0013) and registered with the Scientific Ethical Committee (H-C-FSP-2010-049). This study is registered on ClinicalTrials.gov with the trial identifier NCT04198688.

Author contributors

MR, SVL, and HT contributed to the study conception and design. MR and HT headed the data acquisition. MR contributed to the data analysis. SVL, MR, BTJ, SOD, and HT contributed to the data interpretation. SVL and MR drafted the manuscript, and SVL, MK, BTJ, SOD, and HT revised it critically for important intellectual content. All the authors gave final approval of the version to be published.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The anonymised data and statistical codes that support the findings of this study are available upon request from the corresponding author (SVL).

Data sharing statement

The anonymised data and statistical codes that support the findings of this study are available upon request from the corresponding author (SVL) and will not be shared publicly.

Additional information

Funding

This study was supported by the Danish Cancer Society under grant number R223-A13094. The Parker Institute, Bispebjerg, and Frederiksberg Hospital are supported by a core grant from the Oak Foundation (OCAY‐18‐774‐OFIL).