title: Efficacy of a tobacco quitline among adult survivors of childhood cancer.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN; rklesges@uthsc.edu.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Klesges
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN;
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Krukowski
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: James L
authors.initials: JL
authors.lastname: Klosky
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: Deo Kumar
authors.initials: DK
authors.lastname: Srivastava
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: James M
authors.initials: JM
authors.lastname: Boyett
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: Jennifer Q
authors.initials: JQ
authors.lastname: Lanctot
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: Charla
authors.initials: C
authors.lastname: Folsom
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN;
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
mesh_terms: D000328:Adult; D003367:Cotinine; D003376:Counseling / Q000379:methods*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D009369:Neoplasms; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D017741:Survivors; D013689:Telephone; D062789:Tobacco Products; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D003367:Cotinine