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Eliminating barriers

Conquest - Summer 2013

New approaches help 
smokers quit

By Katrina Burton and Joey Tran

MD Anderson understands that when it comes to quitting smoking, one approach doesn’t fit everyone. That’s why researchers and physicians spend long hours trying to understand smoking addiction and designing programs that might help smokers give up this life-threatening habit. 

Two recent initiatives are showing promise for many. One involves a drug that could help relieve the side effects of quitting, the other shows the benefits of counseling.

Anti-smoking drugs help kick the habit for good

Quitting can be tough, no matter how long you’ve been smoking. However, recent findings from an MD Anderson comparative study of two popular smoking cessation drugs showed that smokers can come closer to eliminating their smoking habits.

“When smokers try to quit, many are likely to experience a range of nicotine withdrawal symptoms, including negative mood, difficulty concentrating, irritability and even depression making quitting difficult and increasing the chances of relapse,” says Paul Cinciripini, Ph.D., professor in MD Anderson’s Department of Behavioral Science and lead investigator on the study.

He believes that minimizing these withdrawal symptoms could help smokers strengthen their quit-smoking attempt, especially when it’s will power versus habit.

Paul Cinciripini

Paul Cinciripini, Ph.D., professor, 
Department of Behavioral Science
Photo: F. Carter Smith

Addressing withdrawal symptoms

Fortunately, the study revealed an increased probability of quitting and a less unpleasant smoking-cessation experience among smokers taking varenicline, compared to those on bupropion or a placebo. Cinciripini also provided intensive counseling during the process.

“The more we can reduce these negative symptoms associated with quitting, the better the smoker’s experience. This may mean that even if they don’t quit this time, they’ll be encouraged to try again,” he says.

The study, funded by the National Institute on Drug Abuse, included 294 smokers randomized into three groups. All participants received smoking cessation counseling from QuitRx, alongside their corresponding anti-smoking medication or placebo.

QuitRx is an MD Anderson research study designed to better understand how the brain responds when people experience negative emotions (e.g., agitation, irritability, sadness) often associated with quitting.

The findings showed that varenicline was more effective in minimizing depressive symptoms and cravings, and could even eliminate the psychological reward or pleasure gained from smoking.

“It’s evident from the findings that varenicline is hitting many more effective targets, in comparison to bupropion or a placebo,” Cinciripini says. “There’s a distinct benefit of these effects on cessation even among those who don’t fully abstain.”

Jennifer Irvin

Jennifer Irvin Vidrine, Ph.D., 
associate professor, Department
of Health Disparities Research
Photo: F. Carter Smith

Ask Advise Connect: A quit-smoking approach

Self-identified smokers directly connected to a tobacco cessation quitline are 13 times more likely to enroll in a treatment program as compared to smokers who are handed a quitline referral card and encouraged to call on their own.

The study, published in the Journal of the American Medical Association Internal Medicine, evaluated a new approach to linking smokers in health care settings with evidence-based smoking cessation treatment delivered via the Texas Quitline. Called Ask Advise Connect, the program was designed to eliminate barriers to treatment.

“The study’s primary outcome was impact - defined as the proportion of all identified smokers who enrolled in smoking-cessation treatment with the Quitline,” says Jennifer Irvin Vidrine, Ph. D., associate professor in MD Anderson’s Department of Health Disparities Research and principal investigator on the study.

Licensed vocational nurses and medical assistants at 10 Kelsey-Seybold Family Practice clinics were trained to ask all patients about their smoking status at the time vital signs were collected, to record this information in the electronic health record (EHR), provide all smokers with brief advice to quit and to connect smokers with the Quitline through an automated link within the EHR.

“The findings reflect one of the highest rates of tobacco-cessation treatment enrollment reported in the literature to date,” Vidrine says. “Given that smoking is the leading cause of preventable morbidity and mortality in the United States, Ask Advise Connect has tremendous potential to make a significant public health impact if adopted broadly by other health care systems.” 

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