Partnership for Health

Thanks to treatment successes over the last several decades, many forms of childhood cancer have evolved from highly lethal diseases to typically curable conditions. As a result, childhood cancer survivors represent a large and growing group, and treatment issues have expanded to include managing survivors' care and preventing adverse late effects, including second primary cancers. A recent analysis of smoking prevalence using data from the Childhood Cancer Survivors Study (CCSS) reveals that childhood cancer survivors are smoking at a similar or slightly lower rate than age- and gender-matched groups from the general population. The CCSS illustrates that 17% of survivors are active smokers and another 10% are former smokers.

The program consists of telephone counseling delivered by trained childhood cancer survivors, tailored and targeted self-help intervention materials, and nicotine replacement therapy.

Participants in the telephone counseling intervention receive peer-delivered telephone counseling, tailored and targeted Partnership for Health intervention materials, and free nicotine replacement therapy for themselves and their spouses or partners. Peer counselors who are also childhood cancer survivors staff the telephone-delivered counseling program. Each participant is assigned a peer counselor who works with them throughout the intervention. Counselors focus on smoking cessation strategies with participants who express interest in smoking cessation and on building motivation for those who are not ready to quit. Nicotine replacement therapy is available for those who are in the preparation stage of readiness to quit.

In the study, peer counselors made up to 6 calls over 7 months.

The study focused on childhood cancer survivors who indicated they were current smokers. The study sample was recruited from the Childhood Cancer Survivors study, consisting predominantly of Caucasian young adults, though also included African American and Hispanic people of origin. All study participants were diagnosed with cancer before age 21 and were at least 18 years of age at time of baseline.

The program can be administered in the home via telephone or by mail.

Required materials include a training manual to train the telephone counselors, the Partnership for Health cessation manual (four sessions targeted to a stage of change), Tip Sheets, a Tailored Data Profile to tailor the intervention based on the initial client contact, and a Personal Health Profile tailored to the client's interest in quitting smoking and type of cancer treatment received as a child. Access to nicotine replacement therapy should also be available.

Participants were randomly assigned to either (1) a peer-delivered telephone counseling intervention or (2) a self-help intervention.

Participants in the telephone counseling intervention received peer-delivered telephone counseling, tailored and targeted Partnership for Health intervention materials, and free nicotine replacement therapy for themselves and their spouses or partners. Follow-up took place at 8 and 12 months.

Results of the study include the following:

• At the 8-month follow-up, 14.5% of all participants had quit smoking.
• The quit rate was significantly higher in the intervention group when compared with controls (16.8% vs. 8.5%). This difference was maintained at 12-month follow-up (15% vs. 9%).
• Between the 8- and 12-month surveys, 18% of all participants made at least one attempt to quit; 32% of the intervention group and 25% of the control group had tried to quit at least twice during this period.