MUSC Hollings Cancer Center has a robust smoking cessation program. Every person who walks through the doors and answers 'yes' that they smoke in a patient questionnaire gets a call with an invitation to receive free counseling and evidence-based assistance to quit.
But about a quarter of those reached decline any help.
Now, a trial will study a new quit-smoking option for those who would otherwise decline the program: e-cigarettes.
Tracy Smith, Ph.D., and Alana Rojewski, Ph.D., both researchers with the Cancer Prevention and Control program at Hollings, are working together on the study, funded by the National Cancer Institute.
Their goal is to provide more options to people looking to quit smoking and to assess whether e-cigarettes might be one answer.
Smith and Rojewski's study builds upon an earlier pilot project.
"It was small, but four of the 10 people switched completely from cigarettes to e-cigarettes. That was enough for us to feel like we should do a larger trial," Smith said.
"Most people reported that they refused all evidence-based treatment because they had tried all those things in the past, and nothing had worked for them. They were tired of trying these strategies that were ineffective for them. So they were willing to try anything else that was new and could potentially help them."Alana Rojewski, Ph.D.
The team also uncovered an unexpected perspective from the pilot participants. During interviews at the end of the pilot, they asked participants about their reasons for declining the smoking cessation program when it was offered.
"We expected this to be a group of people who smoke and had low motivation to quit, and that's why they were refusing the available treatment options," Rojewski said. "But that is not actually what they reported. Most people reported that they refused all evidence-based treatment because they had tried all those things in the past, and nothing had worked for them. They were tired of trying these strategies that were ineffective for them.
"So they were willing to try anything else that was new and could potentially help them."
E-cigarettes are not a completely harm-free product. However, they are less harmful than traditional combustible cigarettes, which not only can cause cancer but also shorten a patient's lifespan after cancer treatment. "This is an intervention that is truly harm reduction in the sense that it is aimed at reducing patient risk in this very critical time window, especially for those patients who are here for active cancer treatment – their cancer outcomes are on the table," Rojewski said.
The trial is expected to begin in May and will be offered to all Hollings Cancer Center patients reached through the Tobacco Treatment Program who don't want an existing, approved smoking cessation aid. The Tobacco Treatment Program operates throughout the MUSC Health system, including Regional Health Network hospitals across the state.
Those who agree to participate in the trial will receive either an e-cigarette with instructions to switch away from combustible cigarettes completely or a quit-smoking workbook and an invitation to rejoin the tobacco treatment program at any time.
In addition, the team is collaborating with Shikhar Mehrotra, Ph.D., co-leader of the Cancer Biology and Immunology program at Hollings, to collect and study inflammatory biomarkers associated with cancer risk.
"We're looking at what the potential reduction in risk is," Rojewski said. "Moving from combusted cigarettes to e-cigarettes could potentially reduce inflammation among people who smoke, so we're excited to take a look at these biomarkers."
