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Intervention to Reduce Intentions to Use Tobacco Among Pediatric Cancer Survivors

Vida L. Tyc, Shesh N. Rai, Shelly Lensing, James L. Klosky, Deborah B. Stewart, Jami Gattuso

From the Division of Behavioral Medicine, the Department of Biostatistics, and the Department of Nursing, St. Jude Children’s Research Hospital; and the Department of Pediatrics, University of Tennessee, College of Medicine, Memphis, TN.

Address reprint requests to Vida L. Tyc, PhD, Division of Behavioral Medicine, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794; email: vida.tyc{at}stjude.org.

Purpose: In this randomized controlled trial, we sought to determine whether a risk counseling intervention would increase knowledge and perceived vulnerability to tobacco-related health risks and decrease future intentions to use tobacco among preadolescents and adolescents previously treated for cancer.

Patients and Methods: Participants included 103 cancer survivors between the ages of 10 and 18 years who were randomly assigned to either a standard care control (SCC) group or a tobacco intervention (TI) group. Patients in the SCC group received standard advice about the risks of tobacco use. Patients in the TI group received more intensive late effects risk counseling in addition to an educational video, goal setting, written physician feedback, smoking literature, and follow-up telephone counseling. The effect of our intervention was assessed by self-reported knowledge, perceived vulnerability, and intentions at baseline, 6, and 12 months.

Results: Compared with the SCC group, patients who received our intervention had significantly higher knowledge scores, higher perceived vulnerability scores, and lower intention scores at 12 months. No significant differences between the SCC and TI groups at 6 months, across all measures, were found.

Conclusion: Pediatric survivors’ knowledge, perceived vulnerability to health risks, and intentions to use tobacco can be modified by a risk counseling intervention. The delayed effect of our intervention indicates that these changes may evolve over time. Implications for health care providers who engage in tobacco counseling with young cancer survivors are discussed. Additional longitudinal studies are needed to determine definitive long-term intervention effects on actual tobacco use in this high-risk population.

Supported in part by grants CA 21765 and CA 70267 from the National Cancer Institute and the American Lebanese Syrian Associated Charities (ALSAC).

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