Cancer Risk Reduction Through Combined Treatment for Tobacco and Alcohol Use

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Cancer Risk Reduction Through Combined Treatment for Tobacco and Alcohol Use

Conditions
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Head and Neck Cancer, Tobacco Use Disorder

Intervention / Treatment
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* Behavioral: smoking cessation intervention
* Other: counseling intervention
* Other: preventive intervention
* Other: questionnaire administration


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| MAPS+<br>MAPS+ (Motivation and Problem-Solving Plus): Counseling using specific treatment approach that focuses on combined smoking cessation and the reduction of at-risk alcohol use. | Behavioral: smoking cessation intervention<br>* Standard quit-smoking counseling to help decrease their risk of cancer.<br>Other: counseling intervention<br>* Counseling focusing on decreasing risk of getting cancer by decreasing smoking and alcohol use.<br>Other: preventive intervention<br> <br> Other: questionnaire administration<br> <br> * Other names: survey;|
| MAPS<br>MAPS (Motivation and Problem-Solving): Counseling treatment approach with a focus on smoking cessation. | Behavioral: smoking cessation intervention<br>* Standard quit-smoking counseling to help decrease their risk of cancer.<br>Other: questionnaire administration<br> <br> * Other names: survey;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participant At-risk drinking status |  | 52 weeks | 
| Smoking cessation |  | 52 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hypopharyngeal cancer, laryngeal cancer, lip and oral cavity cancer, nasopharyngeal cancer, oropharyngeal cancer, paranasal sinus and nasal cavity cancer, tobacco use disorder