Smoking Cessation Support for Cervical Cancer Survivors

Overseen By Sarah Jones

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: H. Lee Moffitt Cancer Center and Research Institute

Disqualifiers: Tobacco treatment, Household member enrolled

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 24 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help cervical cancer survivors quit smoking by testing two different approaches. One group will receive motivation and problem-solving counseling through phone calls, along with personalized text messages. The other group will receive standard support from the Tobacco Free Florida Quitline. Participants must be Florida residents with a history of cervical cancer or high-grade cervical dysplasia, who currently smoke and own a smartphone.

As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance smoking cessation strategies for cervical cancer survivors.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are already receiving any tobacco treatment, either behavioral or with medication.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that the Motivation and Problem Solving (MAPS) program is being tested to help people quit smoking, particularly those who have had cervical cancer. While detailed safety information is not yet available, similar studies have evaluated its effectiveness and safety. This trial is marked "Not Applicable" for phase, indicating it does not involve new drugs requiring strict safety testing. This suggests that the methods used, such as counseling and text messages, are likely safe and easy to use. Participants will also use nicotine replacement therapy (NRT), including patches and lozenges, which many have used safely to quit smoking. No major safety concerns have been reported for NRT when used as directed. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Motivation and Problem Solving (MAPS) intervention for smoking cessation in cervical cancer survivors because it offers a personalized approach. Unlike standard options, which typically involve a generic connection to a quitline and nicotine replacement therapy, MAPS provides tailored support through a series of counseling calls and customized text messages. These features are designed to address individual motivations and challenges, potentially increasing the chances of successfully quitting smoking. Additionally, the intervention spans a longer period, offering ongoing support for up to 24 months, which might lead to more sustained smoking cessation outcomes.

What evidence suggests that this trial's treatments could be effective for smoking cessation in cervical cancer survivors?

Research has shown that the Motivation and Problem Solving (MAPS) program, which participants in this trial may receive, can help people quit smoking. Studies have found that MAPS, which includes personalized counseling and support through text messages, increases the chances of quitting smoking permanently. People using MAPS tend to avoid tobacco for longer periods. This program is specially designed for individuals with a history of cancer, making it an excellent option for cervical cancer survivors who want to quit smoking. ^{2 6 7 8 9}

Who Is on the Research Team?

Jennifer Vidrine, PhD, MS

Principal Investigator

Moffitt Cancer Center

Are You a Good Fit for This Trial?

This trial is for individuals in Florida who have a history of cervical cancer or high-grade cervical dysplasia, currently smoke cigarettes, and have smoked at least 100 in their lifetime. They must speak English and own a working smartphone. People can't join if they live with someone already enrolled, cannot use nicotine replacement due to medical reasons, or are undergoing other tobacco treatments.

Inclusion Criteria

Currently smoke 1 cigarette or more in the past 30 days

Has a valid home address

Has a working smartphone

Exclusion Criteria

Household member enrolled in this study

I am currently getting treatment to help me stop smoking.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a 12-week supply of nicotine replacement therapy and MAPS intervention, including 6 counseling calls over 12 months and tailored SMS content for 24 months

24 months

6 counseling calls, monthly smartphone check-ins

Follow-up

Participants are monitored for smoking abstinence and effectiveness of the treatment

24 months

What Are the Treatments Tested in This Trial?

Interventions

• Motivation and Problem Solving (MAPS) intervention
• Nicotine Lozenge
• Nicotine patch
• Smoking Cessation treatment delivered by Tobacco Free Florida Quitline

Trial Overview The study tests the effectiveness of combining MAPS-based telephone counseling with tailored text messages versus standard quitline smoking cessation treatment. Participants will receive either nicotine patches or lozenges as part of their therapy.

How Is the Trial Designed?

Group I: Group 2: Motivation and Problem Solving (MAPS) counseling Experimental Treatment 3 Interventions

Participants will receive a 12 week supply of nicotine replacement therapy (the patch and lozenges) along with the MAPS intervention, which consists of 6 MAPS counseling calls over 12 months, and individually tailored SMS text content driven by monthly smartphone delivered check-ins for 24 months

Group II: Group 1: Standard Treatment Active Control 3 Interventions

Participants will receive a connection to the Tobacco Free Florida Quitline and a 12 week supply of nicotine replacement therapy (the patch and lozenges)

Who Is Running the Clinical Trial?

H. Lee Moffitt Cancer Center and Research Institute

Lead Sponsor

Trials

576

Recruited

145,000+

James and Esther King Biomedical Research Program

Collaborator

Trials

15

Recruited

2,200+

Published Research Related to This Trial

Cervical cancer survivors from low socioeconomic backgrounds often do not recognize the link between smoking and their cancer, believing their diagnosis is solely due to human papillomavirus, indicating a need for targeted education in cessation programs.

Participants emphasized the importance of a supportive and nonjudgmental approach in smoking cessation treatment, suggesting that effective programs should include psychoeducation, coping strategies, and address stress management and lifestyle changes specific to their survivorship experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smoking Cessation Treatment Needs of Low SES Cervical Cancer Survivors. Hoover, DS., Spears, CA., Vidrine, DJ., et al.[2023]

A randomized clinical trial involving 202 cervical cancer survivors is evaluating the efficacy of the MAPS approach for smoking cessation, which includes proactive counseling and standard treatment components over 12 months.

The study aims to determine if the MAPS intervention is more effective than standard treatment in helping these women quit smoking, with significant public health implications if proven successful.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the Efficacy of a Smoking Cessation Intervention for Cervical Cancer Survivors and Women With High-Grade Cervical Dysplasia: Protocol for a Randomized Controlled Trial. Jones, SR., Vidrine, DJ., Wetter, DW., et al.[2022]

Among 10,720 participants using a state quitline, 19.8% reported having mental health conditions (MHC), and those with MHC had lower quit rates (16.4%) compared to those without MHC (21.5%).

Participants with MHC were found to be 23% less likely to quit smoking, indicating that while quitline services are utilized by this population, additional support may be necessary to improve their cessation outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cessation among state quitline participants with a mental health condition. Kerkvliet, JL., Wey, H., Fahrenwald, NL.[2018]

Participants in the South Dakota QuitLine who received coaching along with varenicline had the highest abstinence rate at 49.8%, compared to lower rates for other service combinations, indicating that this combination is particularly effective for quitting tobacco.

Overall, the study found that all cessation services offered by the QuitLine resulted in abstinence rates of 40% or greater, demonstrating the effectiveness of these support options for tobacco users motivated to quit.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tobacco quitline outcomes by service type. Kerkvliet, JL., Fahrenwald, NL.[2018]

A randomized clinical trial is underway to evaluate the effectiveness of a novel SMS-delivered digital treatment (MAPS+) combined with a phone counseling approach for smoking cessation among 340 cervical cancer survivors, building on previous findings that showed MAPS doubled smoking abstinence rates at 12 months.

The study aims to determine if the addition of a 24-month digital treatment can enhance long-term smoking cessation success compared to standard treatment, which could have significant implications for public health and support for cancer survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing long-term smoking abstinence among individuals with a history of cervical intraepithelial neoplasia or cervical cancer (Project ACCESS): protocol for a randomized clinical trial. Vidrine, JI., Fennell, BS., Simmons, VN., et al.[2023]

A motivationally tailored phone counseling program for female smokers at risk for cervical cancer was well accepted, with 79% enrollment and 90% completion of calls, regardless of their initial motivation to quit smoking.

Participants receiving the counseling had a higher 7-day point-prevalence abstinence rate at 6 months (20% vs. 12% for usual care), indicating that the intervention effectively encouraged smoking cessation, although the difference in abstinence rates diminished by 12 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Proactive, motivationally enhanced smoking cessation counseling among women with elevated cervical cancer risk. McClure, JB., Westbrook, E., Curry, SJ., et al.[2022]

The study involved 603 low socioeconomic status smokers and found that the Motivation And Problem Solving (MAPS) counseling approach significantly increased enrollment in Quitline services compared to standard treatment.

The provision of Nicotine Replacement Therapy (NRT) did not enhance Quitline enrollment, suggesting that the MAPS intervention alone is effective in reaching underserved populations for tobacco cessation support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing treatment enrollment among smokers who are not motivated to quit: a randomized clinical trial. Vinci, C., Lam, C., Schlechter, CR., et al.[2022]

The implementation of a new model for QUITPLAN Services in Minnesota, which offered more choices and reduced registration barriers, led to a 169% increase in registrations among tobacco users, reaching 15,861 participants in just one year.

The program resulted in high quit attempt rates (83.7%) and a 30-day abstinence rate of 26.1%, demonstrating that providing diverse cessation options can effectively engage smokers and improve their chances of quitting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing reach by offering choices: Results from an innovative model for statewide services for smoking cessation. Keller, PA., Schillo, BA., Kerr, AN., et al.[2018]

A study involving 2,041 participants showed that a telephone-based smoking cessation program (quitline) significantly reduced the number of cigarettes smoked per day, indicating its effectiveness in promoting smoking cessation.

The analysis found that missing data did not systematically affect the outcomes of cigarette reduction, suggesting that the quitline's efficacy is robust even when some participants miss calls, and highlights the importance of considering nicotine dependence in evaluating treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trajectories of cigarettes per day during the course of telephone tobacco cessation counseling services: a comparison of missing data models. Witkiewitz, K., Bush, T., Magnusson, LB., et al.[2018]

The MAPS intervention significantly increased smoking abstinence rates among women with a history of cervical intraepithelial neoplasia or cervical cancer at 12 months, achieving 26.4% abstinence compared to 11.9% in the standard treatment group.

At 18 months, the difference in abstinence rates between MAPS and standard treatment was no longer significant, indicating that while MAPS was effective in the short term, its long-term efficacy may need further support to maintain smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of a Smoking Cessation Intervention for Survivors of Cervical Intraepithelial Neoplasia or Cervical Cancer: A Randomized Controlled Trial. Vidrine, JI., Sutton, SK., Wetter, DW., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8765796/

Evaluation of the Efficacy of a Smoking Cessation ... This study will yield crucial information regarding the efficacy and cost-effectiveness of a MAPS approach for smoking cessation tailored to the specific needs ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/34967755/

Evaluation of the Efficacy of a Smoking Cessation Intervention ... The primary outcome is abstinence from tobacco at 18 months. Secondary outcomes include abstinence over time across all assessment points, ...

3. maps.cancer.gov maps.cancer.gov/overview/DCCPSGrants/abstract.jsp?applId=9063397&term=CA172786

Division of Cancer Control & Population Sciences - Grant Details This study will evaluate the efficacy and cost-effectiveness of a theoretically- and empirically- based "Motivation And Problem-Solving" (MAPS) approach for ...

4. ascopubs.org ascopubs.org/doi/abs/10.1200/JCO.22.01228

Efficacy of a Smoking Cessation Intervention for Survivors ... The purpose of this study was to evaluate the long-term efficacy of Motivation And Problem Solving (MAPS), a novel treatment well-suited to meeting the smoking ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0749379724000436

Smoking Cessation by Cancer Treatment Status Among ... Using data from a smoking cessation RCT, this study compared long-term cessation outcomes of women undergoing active treatment for cervical cancer at trial ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11231988/

Smoking Cessation by Cancer Treatment Status Among ... Using data from a smoking cessation RCT, this study compared long-term cessation outcomes of women undergoing active treatment for cervical cancer at trial ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT02157610

Smoking Cessation for Cervical Cancer Survivors The goal of this research study is to compare a program called Motivation And Problem-Solving (MAPS) to the standard treatment to help participants with a ...

8. ajpmfocus.org ajpmfocus.org/article/S2773-0654(25)00049-5/fulltext

Early Treatment Engagement and Long-Term Smoking ... Although data indicate that greater tobacco cessation treatment engagement leads to better cessation outcomes in cancer survivors, little is ...

9. bmcpublichealth.biomedcentral.com bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16189-3

Enhancing long-term smoking abstinence among individuals ... The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed.