Originally published as JCO Early Release 10.1200/JCO.2005.07.048 on August 22 2005

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Peer-Delivered Smoking Counseling for Childhood Cancer Survivors Increases Rate of Cessation: The Partnership for Health Study

From the Dana-Farber Cancer Institute/Harvard School of Public Health; Massachusetts General Hospital/Harvard Medical School, Boston; University of Massachusetts–Amherst, Amherst, MA; University of Minnesota, Minneapolis, MN; The University of Texas M.D. Anderson Cancer Center, Houston, TX

Address reprint requests Karen M. Emmons, PhD, Harvard School of Public Health and Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney Street, Boston, MA 02115; e-mail: Karen_M_Emmons{at}dfci.harvard.edu

PURPOSE: Cancer survivors smoke at rates that are only slightly lower than the general population. This article reports on the final outcomes of Partnership for Health, a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study (CCSS).

METHODS: This study is a randomized control trial with follow-up at 8 and 12 months that involved smokers (n = 796) enrolled onto the CCSS cohort. Participants were randomly assigned to either a self-help or a peer-counseling program that included up to six telephone calls from a trained childhood cancer survivor, tailored and targeted materials, and free nicotine replacement therapy. The intervention was delivered by telephone and postal service mail.

RESULTS: The quit rate was significantly higher in the counseling group compared with the self-help group at both the 8-month (16.8% v 8.5%; P < .01) and 12-month follow-ups (15% v 9%; P .01). Controlling for baseline self-efficacy and readiness to change, the intervention group was twice as likely to quit smoking, compared with the self-help group. Smoking cessation rate increased with an increase in the number of counseling calls. The cost of delivering the intervention was approximately $300 per participant. The incremental cost-effectiveness of the intervention compared with controls was $5,371 per additional quit.

CONCLUSION: Interventions to prevent future illnesses are of critical importance to childhood cancer survivors. The Partnership for Health intervention resulted in a doubling of smoking cessation quit rates. Because of the seriousness of smoking among childhood cancer survivors, this intervention model may be appropriate as a multicomponent treatment program for survivors who smoke.

Supported by Grants No. U24-CA55727 and RO1-CA77780 from the National Institutes of Health; support provided to the University of Minnesota by the Children's Cancer Research Fund; support to the Dana-Farber Cancer Institute by Liberty Mutual, the Patterson Fellowship Fund, and the Harry and Elsa Jiler American Cancer Society Research Professorship (F.P.L.). SmithKline Beecham donated nicotine patches.

Presented in part at a paper session at the 24th Annual Meeting and Scientific Sessions of the Society for Behavioral Medicine, Salt Lake City, UT, March 19-23, 2003.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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