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Virtual sustained treatment increases 6-month abstinence rates to 28.4% compared to 14.7% in cancer patientsVirtual counseling and nicotine therapy help cancer patients quit smoking

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Key Takeaway
Consider virtual sustained treatment to improve smoking cessation rates among patients recently diagnosed with cancer.

This randomized controlled trial enrolled 306 English- and Spanish-speaking patients recently diagnosed with cancer across nationwide community oncology settings. The study compared virtual sustained treatment (VST) to enhanced usual care (EUC). VST consisted of up to 11 synchronous telehealth sessions of motivational counseling and up to 12 weeks of free nicotine replacement therapy (NRT). EUC involved referral to the National Cancer Institute quitline.

At the 6-month, 7-day point, abstinence rates were 28.4% in the VST group (42 of 148) versus 14.7% in the EUC group (21 of 143). Participants who completed more than 8 sessions were significantly more likely to quit compared to those with fewer than 5 sessions (p =.005). Additionally, VST participants were almost four times more likely to report guideline-concordant smoking cessation medication use. Higher continuous abstinence and significant reduction rates at 6 months were also observed in the VST group.

No specific safety data or adverse events were reported for either intervention. The study highlights that VST may be a viable model for integrating tobacco treatment into oncology care. However, clinicians should note that the increased likelihood of medication use is a relative measure and individual patient factors remain critical.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in managing supportive care for cancer patients by providing evidence for effective smoking cessation interventions. While previous coverage has focused on coping mechanisms, inflammation-immunity-nutrition scores as prognostic markers, AI in endoscopic procedures, skin rash risks from PD-1 inhibitors, and pediatric palliative care standards, this study specifically addresses tobacco cessation within the oncology population.

Living with a cancer diagnosis is hard enough without the added struggle of a nicotine addiction. For many patients, quitting smoking is a vital step for their health, but it can be incredibly difficult to do alone. A recent study looked at how different types of support could help these patients break free from tobacco.

The researchers compared two methods. One group received virtual sustained treatment (VST), which included up to 11 online counseling sessions and 12 weeks of free nicotine replacement therapy. The other group received standard care, which was a referral to a quitline. The results showed that the virtual program was much more effective. About 28.4% of people in the virtual group were smoke-free at six months, compared to only 14.7% in the standard care group.

The study also found that consistency matters. Patients who completed more than eight sessions were significantly more likely to quit than those who attended fewer than five. Additionally, those in the virtual program were almost four times more likely to use medications that meet official health guidelines. While the study did not report any specific safety issues or side effects, it suggests that consistent, remote support can be a powerful tool for cancer patients trying to quit smoking.

What this means for you:
Virtual coaching and nicotine therapy significantly improve smoking quit rates for people recently diagnosed with cancer.

Common questions

How does the virtual treatment compare to standard care?

The virtual sustained treatment (VST) was much more effective than standard care. In the study, 28.4% of patients in the VST group were smoke-free at six months, while only 14.7% of those receiving standard care reached that same goal.

Does the number of sessions matter for success?

Yes, staying consistent is key. The study found that patients who completed more than 8 sessions were significantly more likely to quit smoking than those who attended fewer than 5 sessions.

What kind of medication was used in the virtual program?

The virtual program included up to 12 weeks of free nicotine replacement therapy. Patients in this group were almost four times more likely to use medications that follow official health guidelines compared to those in the standard care group.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up2.8 mo
PublishedAug 2026
View Original Abstract ↓
PURPOSE: Persistent smoking among patients diagnosed with cancer is associated with adverse clinical outcomes, yet tobacco treatment has not been integrated into community oncology settings. We conducted a trial of a virtual sustained tobacco treatment intervention across community oncology settings nationwide. METHODS: This randomized controlled trial compared the effectiveness of sustained telehealth counseling plus medication (virtual sustained treatment [VST]) to referral to the National Cancer Institute (NCI) quitline (enhanced usual care [EUC]) in assisting patients recently diagnosed with cancer to quit smoking. The VST group received up to 11 synchronous telehealth sessions (four weekly, four biweekly, three monthly) of motivational counseling and up to 12 weeks of free nicotine replacement therapy (NRT). RESULTS: From August 2019 to December 2022, 306 English- and Spanish-speaking patients were randomly assigned from 37 NCI Community Oncology Research Program community sites. Participants were 70.9% female; 86.3% was White; the median age was 57 years; and 45.4% had non-smoking-related tumors. A total of 221 of 302 (73.2%) smoked within 30 minutes of waking. Six-month, 7-day point abstinence rates were 28.4% (42 of 148) in the VST group versus 14.7% (21 of 143) in the EUC group; there were no significant treatment moderators. A total of 80.8% (126 of 156) of VST participants engaged in counseling, and 85.7% (108 of 126) were dispensed NRT. Participants who completed >8 sessions versus <5 sessions were more likely to quit; = .005. VST participants were almost four times more likely to report guideline-concordant smoking cessation medication use. Continuous abstinence and significant reduction rates at 6 months were higher in the VST group. The incremental cost per quit was $7,724 in US dollars. CONCLUSION: Among recently diagnosed patients, sustained remotely delivered telehealth counseling and free NRT were well utilized and nearly doubled 6-month quit rates compared with EUC. Findings support the benefit of adopting sustained tobacco treatment within community oncology care settings nationwide.
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