A Tailored Smoking, Alcohol, and Depression Intervention for Head and Neck Cancer Patients
- Sonia A. Duffy1,2,3,
- David L. Ronis1,4,
- Marcia Valenstein1,3,
- Michael T. Lambert5,6,
- Karen E. Fowler1,
- Lynn Gregory2,
- Carol Bishop8,
- Larry L. Myers5,7,
- Frederic C. Blow1 and
- Jeffrey E. Terrell2
- 1Veterans Affairs's Health Services Research and Development Service, Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System; Departments of 2Otolaryngology and 3Psychiatry, University of Michigan Medical School, 4School of Nursing, University of Michigan, Ann Arbor, Michigan; 5North Texas Veterans Healthcare System; Departments of 6Psychiatry and 7Otolaryngology, University of Texas Southwestern Medical School, Dallas, Texas; and 8Department of Otolaryngology, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida
- Requests for reprints:
Sonia A. Duffy, Veterans Affairs Health Services Research and Development Service, Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System (11H), P.O. Box 130170, Ann Arbor, MI 48113-0170. Phone: 734-769-7100 ext. 6210; Fax: 734-761-2939. E-mail: Sonia.Duffy{at}med.va.gov
Abstract
Background: Smoking, alcohol use, and depression are interrelated and highly prevalent in patients with head and neck cancer, adversely affecting quality of life and survival. Smoking, alcohol, and depression share common treatments, such as cognitive behavioral therapy and antidepressants. Consequently, we developed and tested a tailored smoking, alcohol, and depression intervention for patients with head and neck cancer.
Methods: Patients with head and neck cancer with at least one of these disorders were recruited from the University of Michigan and three Veterans Affairs medical centers. Subjects were randomized to usual care or nurse-administered intervention consisting of cognitive behavioral therapy and medications. Data collected included smoking, alcohol use, and depressive symptoms at baseline and at 6 months.
Results: The mean age was 57 years. Most participants were male (84%) and White (90%). About half (52%) were married, 46% had a high school education or less, and 52% were recruited from Veterans Affairs sites. The sample was fairly evenly distributed across three major head and neck cancer sites and over half (61%) had stage III/IV cancers. Significant differences in 6-month smoking cessation rates were noted with 47% quitting in the intervention compared with 31% in usual care (P < 0.05). Alcohol and depression rates improved in both groups, with no significant differences in 6-month depression and alcohol outcomes.
Conclusion: Treating comorbid smoking, problem drinking, and depression may increase smoking cessation rates above that of usual care and may be more practical than treating these disorders separately. (Cancer Epidemiol Biomarkers Prev 2006;15(11):2203–8)
Footnotes
-
Grant support: The Department of Veterans Affairs IIR98-500, GlaxoSmithKline through the Managed Care Forum, and the NIH through the University of Michigan's Head and Neck Specialized Programs of Research Excellence grant 1P50 CA97248.
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
- Accepted August 16, 2006.
- Received November 14, 2005.
- Revision received August 7, 2006.
