title: Research Priorities, Measures, and Recommendations for Assessment of Tobacco Use in Clinical Cancer Research.
abstract: There is strong evidence that cigarette smoking causes adverse outcomes in people with cancer. However, more research is needed regarding those effects and the effects of alternative tobacco products and of secondhand smoke, the effects of cessation (before diagnosis, during treatment, or during survivorship), the biologic mechanisms, and optimal strategies for tobacco dependence treatment in oncology. Fundamentally, tobacco is an important source of variation in clinical treatment trials. Nevertheless, tobacco use assessment has not been uniform in clinical trials. Progress has been impeded by a lack of consensus regarding tobacco use assessment suitable for cancer patients. The NCI-AACR Cancer Patient Tobacco Use Assessment Task Force identified priority research areas and developed recommendations for assessment items and timing of assessment in cancer research. A cognitive interview study was conducted with 30 cancer patients at the NIH Clinical Center to evaluate and improve the measurement items. The resulting Cancer Patient Tobacco Use Questionnaire (C-TUQ) includes "Core" items for minimal assessment of tobacco use at initial and follow-up time points, and an "Extension" set. Domains include the following: cigarette and other tobacco use status, intensity, and past use; use relative to cancer diagnosis and treatment; cessation approaches and history; and secondhand smoke exposure. The Task Force recommends that assessment occur at study entry and, at a minimum, at the end of protocol therapy in clinical trials. Broad adoption of the recommended measures and timing protocol, and pursuit of the recommended research priorities, will help us to achieve a clearer understanding of the significance of tobacco use and cessation for cancer patients.
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland. landsr@mail.nih.gov.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Land
authors.affiliation: Hollings Cancer Center, Medical University of South Carolina (MUSC), Charleston, South Carolina.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Toll
authors.affiliation: Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Carol M
authors.initials: CM
authors.lastname: Moinpour
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Ostroff
authors.affiliation: Masonic Cancer Center, University of Minnesota (DKH), Minneapolis, Minnesota.
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
authors.affiliation: College of Nursing and VA Center for Clinical Management Research, HSR&D Center of Excellence, The Ohio State University, Columbus, Ohio.
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
authors.affiliation: Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, Florida.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
authors.affiliation: Coordinating Center for Clinical Trials, National Cancer Institute, Bethesda, Maryland.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Prindiville
authors.affiliation: School of Nursing, University of California, Los Angeles, California.
authors.forename: Linda P
authors.initials: LP
authors.lastname: Sarna
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schnoll
authors.affiliation: Yale School of Medicine, Yale Cancer Center, New Haven, Connecticut.
authors.forename: Roy S
authors.initials: RS
authors.lastname: Herbst
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Cinciripini
authors.affiliation: College of Medicine, Mayo Clinic Cancer Center, Mayo Clinic Phoenix, Phoenix, Arizona.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Leischow
authors.affiliation: Independent Expert, Rockville, Maryland.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Dresler
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
authors.affiliation: Hollings Cancer Center, Medical University of South Carolina (MUSC), Charleston, South Carolina. Department of Radiation Oncology, Medical University of South Carolina (MUSC), Charleston, South Carolina. Department of Cell and Molecular Pharmacology, Medical University of South Carolina (MUSC), Charleston, South Carolina.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Warren
mesh_terms: D026683:Advisory Committees; D017408:Guidelines as Topic; D006801:Humans; D008495:Medical Oncology / Q000379:methods / Q000592:standards; D012106:Research / Q000592:standards; D018570:Risk Assessment; D064424:Tobacco Use / Q000009:adverse effects