cancer risk reduction through combined treatment for tobacco and alcohol use

Conditions: Head and Neck Cancer; Tobacco Use Disorder

Summary: rationale: a counseling program that motivates patients to stop smoking and drinking may reduce the risk of oral cancer. it is not yet known whether motivational stop smoking counseling or motivational stop-smoking and stop drinking counseling is more effective in helping patients stop smoking and drinking. purpose: this randomized clinical trial is studying how well treatment to stop smoking and drinking works in preventing oral cancer in smokers in puerto rico.

objectives: * to evaluate the effects of a motivational and problem-solving smoking cessation (maps) and a motivational and problem solving approach on at-risk alcohol use and smoking cessation (maps+) among puerto rican at-risk drinkers/smokers who call the puerto rico quitline (prq). * to assess effects of maps and maps+ on treatment mechanisms and the role of those mechanisms in mediating these effects on at-risk drinking and smoking cessation. * to evaluate the cost-effectiveness of maps and maps+ in the reduction of at-risk drinking and smoking cessation. outline: minimization randomization is applied using the following variables: age, gender, cigarettes/day, number of drinks/day, and depression (score on the center of epidemiologic studies depression scale). patients are randomized to 1 of 2 intervention arms. * arm i (maps): patients receive culturally sensitive self-help materials tailored for alcohol and tobacco users and 7 telephone counseling calls. the maps approach includes motivational interviewing and cognitive behavioral/problem-solving that focus on smoking cessation. * arm ii (maps+): patients receive culturally sensitive self-help materials tailored for alcohol and tobacco users and 7 telephone counseling calls. the maps+ approach includes motivational interviewing and cognitive behavioral/problems solving that focus on smoking cessation and the reduction of at-risk alcohol use. in both arms, patients receive counseling calls over 15-30 minutes the week before quit date (qd), on qd, 3-5 days after qd, 7-10 days after qd, 15-30 days after qd, 45-60 days after qd, and on day 90 after qd. patients complete questionnaires for alcohol- and smoking-related measures, self efficacy, stress/negative affects/depression, social support, and physical activity at baseline and weeks 12, 26 and 52 after qd.

Eligibility criteria:
disease characteristics: * current daily smoker * called the puerto rico quitline * motivated to quit smoking in the next 30 days * exhibits at least one of the following criteria for at-risk drinking: * an average of ≥ 2 alcoholic beverages/day for men or ≥ 1 drink/day for women in the past 30 days * two or more occasions of consuming ≥ 5 alcoholic beverages/day for men or ≥ 4 drinks/day for women in the past 30 days * driving after consuming ≥ 3 drinks in the past 30 days * score of ≤ 15 on the alcohol use disorders identification test patient characteristics: * not pregnant * residing in puerto rico * not currently incarcerated or in jail * no other household member enrolled in this study * viable telephone number and home address * willing to provide the names, addresses, and phone numbers of up to 3 collaterals prior concurrent therapy: * not specified

Keywords: hypopharyngeal cancer laryngeal cancer lip and oral cavity cancer nasopharyngeal cancer oropharyngeal cancer paranasal sinus and nasal cavity cancer tobacco use disorder