A pilot study of telephone-based smoking cessation intervention in asbestos workers

Our plain-English summary of A pilot study of telephone-based smoking cessation intervention in asbestos workers, by O.Y. Osinubi, J. Moline, E. Rovner, et al (Journal of Occupational and Environmental Medicine, 2003).

The study

• Authors: O.Y. Osinubi, J. Moline, E. Rovner, S. Sinha, M. Perez-Lugo, K. Demissie, H.M. Kipen
• Journal: Journal of Occupational and Environmental Medicine
• Published: 2003;45(5):569-74
• Type of article: Randomized trial
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Smoking markedly increases the risk of asbestos-related lung cancer. We conducted a randomized pilot trial of a telephone-based smoking cessation intervention in asbestos workers. Fifty-nine smokers were assigned to either a control or telephone-based smoking cessation treatment group and were followed-up at 6 months. Intent-to-treat analysis revealed a 16.7% quit rate at 6 months for the intervention group compared to 6.9% for the control group (P = 0.25). Treatment-received quit-rates were 33% for the intervention group and 6.9% for the control group (P = 0.05). The intervention group was twice as likely to use smoking cessation medicines and progressed further along the stage of change continuum compared with the control group. Incorporating telephone-based smoking cessation treatment into medical screening activities for asbestos workers is feasible and the intervention is effective in increasing quit rates at 6 months.

In plain English

This was a small randomized pilot trial testing whether telephone counseling could help asbestos workers stop smoking. Of 639 asbestos workers and retirees who attended medical screening at two centers in New York and New Jersey from May 2000 to May 2001, 89 were current smokers and 59 agreed to take part. Thirty were assigned to brief physician advice plus a telephone counseling program called FREE & CLEAR, with quit-smoking medicines as recommended. Twenty-nine were assigned to brief physician advice, self-help materials and a letter to their own doctor. At 6 months, 40 of the 59 could be interviewed. Counting everyone in the group they were assigned to, 16.7% of the telephone group and 6.9% of the control group reported quitting (P = 0.25), which was not statistically significant. Among the 12 who actually used the telephone program, 4 (33.3%) quit, compared with 2 of 29 (6.9%) controls, with a reported P value of 0.05. The authors concluded that the approach was feasible and effective. They noted that quitting was self-reported rather than confirmed by a biological test, and that the study had limited statistical power.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: randomized pilot trial (feasibility study) with 6-month follow-up; randomization by sealed envelope
• Who was studied: 59 current cigarette smokers out of 639 asbestos workers and retirees who attended medical screening for asbestos-related diseases at the Mount Sinai-Irving J. Selikoff Center (New York) and the UMDNJ-Robert Wood Johnson Medical School clinical center (New Jersey), May 2000 to May 2001. The groups included school and library employees, custodian engineers, firemen, plumbers, pipefitters and sheet metal workers. 89 of the 639 (13.9%) were current smokers, and 59 of those 89 (66.3%) took part: 30 in the intervention group and 29 in the control group.
• Exposure: The comparison was between two smoking-cessation approaches, not between asbestos exposures. The intervention group received brief physician advice plus proactive enrollment in the FREE & CLEAR telephone counseling program, with nicotine replacement therapy and/or bupropion (Zyban) as recommended. The control group received brief physician advice, written instructions to follow up with their personal physician, self-help materials and a local listing of cessation resources. Asbestos fiber types and exposure levels were not reported; mean years in the asbestos trade were 26.5 (intervention) and 28.8 (control).
• Main results:
  • At 6 months, 40 of the 59 participants (68%) were available for telephone interview. Participants lost to follow-up were counted as non-quitters.
  • Intent-to-treat analysis (everyone counted in the group they were assigned to): 16.7% of the intervention group (5 of 30) and 6.9% of the control group (2 of 29) had quit at 6 months (P = 0.25, not statistically significant).
  • Treatment-received analysis: 33.3% (4 of 12) of intervention participants who followed through with FREE & CLEAR had quit, compared with 6.9% (2 of 29) of the control group. The table gives the P value as 0.05.
  • 40% of the intervention group (12 of 30) went on to use the telephone program; 21% of the control group consulted their personal physician for help with quitting.
  • Use of quit-smoking medicines (nicotine replacement and/or bupropion): 30% of the intervention group (9 of 30) versus 17.2% of the control group (5 of 29) (P = 0.36).
  • Among those who kept smoking, intervention participants appeared to have progressed further along the stages of readiness to quit than controls.
  • Among continuing smokers, average daily cigarette use fell slightly and similarly in both groups: by 13.1% in the intervention group and 10.2% in the control group.
• The authors' conclusion: The authors concluded that adding telephone-based smoking cessation treatment to medical screening of asbestos workers is feasible and that the intervention is effective in increasing quit rates at 6 months.
• Limitations the authors state:
  • Smoking status was self-reported; no biomarker such as cotinine was used to confirm it.
  • The intent-to-treat comparison did not reach statistical significance, which the authors attributed likely to limited study power (23%).

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Lung Cancer.

Related studies

• Healthcare provider smoking cessation advice among US worker groups — D.J. Lee, L.E. Fleming, et al. (2007)
• Study of smoking behavior in asbestos workers — O.Y. Osinubi, A.A. Afilaka, et al. (2002)
• Effectiveness of smoking cessation advice for asbestos workers — A. Johnson, P. Farrow, et al. (2006)
• Effectiveness of postal smoking cessation advice: a randomized controlled trial in young men with reduced FEV1 and asbestos exposure — S. Humerfelt, G.E. Eide, et al. (1998)
• Smoking, morbidity, and pulmonary function in a group of ex-asbestos workers: a pilot study — E.D. Richter, H. Tuch, et al. (1986)
• The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking — A. Reid, N.H. de Klerk, et al. (2006)

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