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      Feasibility and Acceptability of Mindfulness-Based Group Visits for Smoking Cessation in Low-Socioeconomic Status and Minority Smokers with Cancer

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          Abstract

          Objective:

          Smoking cessation studies tailored for low-income and racial/ethnic minority cancer patients are limited. African American and low-socioeconomic status (SES) smokers have higher cancer mortality rates and are less likely to use evidence-based smoking cessation treatments compared with white and higher SES counterparts. Mindfulness training is a promising approach to address racial and SES disparities in smoking cessation. The authors assessed the feasibility and acceptability of a mindfulness-based smoking cessation (MBSC) medical group visit for low-income and racially diverse smokers with cancer.

          Design and intervention:

          The authors adapted the integrative medical group visit model used for chronic pain and included the You Can Quit smoking cessation curriculum used at the study site, Tobacco Treatment Center. The program was conducted in eight weekly 2-h visits. The authors then tested the feasibility and acceptability of this intervention for actively smoking cancer patients and cancer survivors in two pilot groups ( N = 18) using a pre–post design.

          Setting/Location:

          This study took place at Boston Medical Center, a large urban safety net academic teaching hospital.

          Outcome measures:

          The authors used a medical group visit intake form to collect data on weekly cigarette intake and home practice. They also gathered additional qualitative data from focus groups and in-depth interviews.

          Results:

          Over 50% of participants ( n = 10) self-identified as black and 56% reported an annual income of $20,000 or less. Over two-thirds of the participants attended four or more of the eight group visits. There was a significant decrease in weekly cigarette intake from 75.1 cigarettes at baseline to 44.3 at 3 months ( p = 0.039). None of the participants quit smoking. Participants were satisfied with the program and reported positive lifestyle changes.

          Conclusion:

          MBSC group visits are feasible and acceptable among racially diverse and low-SES smokers with cancer and should be further studied in a larger cohort.

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          Most cited references41

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          Mindfulness-Based Interventions in Context: Past, Present, and Future

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            Thematic Analysis: Striving to Meet the Trustworthines Criteria

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              Smoking and prostate cancer survival and recurrence.

              Studies of smoking in relation to prostate cancer mortality or recurrence in prostate cancer patients are limited, with few prostate cancer-specific outcomes. To assess the relation of cigarette smoking and smoking cessation with overall, prostate cancer-specific, and cardiovascular disease (CVD) mortality and biochemical recurrence among men with prostate cancer. Prospective observational study of 5366 men diagnosed with prostate cancer between 1986 and 2006 in the Health Professionals Follow-Up Study. Hazard ratios (HRs) for overall, prostate cancer-specific, and CVD mortality, and biochemical recurrence, defined by an increase in prostate-specific antigen (PSA) levels. There were 1630 deaths, 524 (32%) due to prostate cancer and 416 (26%) to CVD, and 878 biochemical recurrences. Absolute crude rates for prostate cancer-specific death for never vs current smokers were 9.6 vs 15.3 per 1000 person-years; for all-cause mortality, the corresponding rates were 27.3 and 53.0 per 1000 person-years. In multivariable analysis, current vs never smokers had an increased risk of prostate cancer mortality (HR, 1.61; 95% confidence interval [CI], 1.11-2.32), as did current smokers with clinical stage T1 through T3 (HR, 1.80; 95% CI, 1.04-3.12). Current smokers also had increased risk of biochemical recurrence (HR, 1.61; 95% CI, 1.16-2.22), total mortality (HR, 2.28; 95% CI, 1.87-2.80), and CVD mortality (HR, 2.13; 95% CI, 1.39-3.26). After adjusting for clinical stage and grade (likely intermediates of the relation of smoking with prostate cancer recurrence and survival), current smokers had increased risk of prostate cancer mortality (HR, 1.38; 95% CI, 0.94-2.03), as did current smokers with clinical stage T1 through T3 (HR, 1.41; 95% CI, 0.80-2.49); they also had an increased risk of biochemical recurrence (HR, 1.47; 95% CI, 1.06-2.04). Greater number of pack-years was associated with significantly increased risk of prostate cancer mortality but not biochemical recurrence. Current smokers of 40 or more pack-years vs never smokers had increased prostate cancer mortality (HR, 1.82; 95% CI, 1.03-3.20) and biochemical recurrence (HR, 1.48; 95% CI, 0.88-2.48). Compared with current smokers, those who had quit smoking for 10 or more years (HR, 0.60; 95% CI, 0.42-0.87) or who have quit for less than 10 years but smoked less than 20 pack-years (HR, 0.64; 95% CI, 0.28-1.45) had prostate cancer mortality risks similar to never smokers (HR, 0.61; 95% CI, 0.42-0.88). Smoking at the time of prostate cancer diagnosis is associated with increased overall and CVD mortality and prostate cancer-specific mortality and recurrence. Men who have quit for at least 10 years have prostate cancer-specific mortality risks similar to those who have never smoked.
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                Author and article information

                Journal
                J Altern Complement Med
                J Altern Complement Med
                acm
                Journal of Alternative and Complementary Medicine
                Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA )
                1075-5535
                1557-7708
                01 July 2019
                16 July 2019
                16 July 2019
                : 25
                : 7
                : 762-769
                Affiliations
                [ 1 ]University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC.
                [ 2 ]Boston Medical Center, Boston, MA.
                [ 3 ]The Pulmonary Center, Boston University School of Medicine, Boston, MA.
                [ 4 ]Department of Family Medicine, University of Massachusetts Medical School, Worcester, MA.
                Author notes

                The preliminary findings of this study were presented, in part, at the 7th Annual Integrative Medicine for the Underserved (IM4US) Conference in Chicago, IL, in August 2017 and the Boston Medical Center Innovative Quality and Patient Safety Reception and Award Ceremony, Boston, MA, on October 2017.

                In the July 2019 issue of The Journal of Alternative and Complementary Medicine (vol. 25 no. 7; 762–769), the article entitled Feasibility and Acceptability of Mindfulness-Based Group Visits for Smoking Cessation in Low-Socioeconomic Status and Minority Smokers with Cancer has been updated on January 24, 2023 after first online publication of July 1, 2019 to reflect Open Access, with copyright transferring to the author(s), and a Creative Commons License (CC-BY) added ( http://creativecommons.org/licenses/by/4.0).

                [*]Address correspondence to: Marjory Charlot, MD, MPH, MSc, Division of Hematology and Oncology, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7305, Chapel Hill, NC 27599 marjory_charlot@ 123456med.unc.edu
                Article
                10.1089/acm.2019.0016
                10.1089/acm.2019.0016
                9889013
                31314565
                ad76ada9-1ce8-4f16-9b8f-d586f5f066b4
                © Marjory Charlot et al 2023; Published by Mary Ann Liebert, Inc.

                This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 3, Tables: 2, References: 43, Pages: 8
                Categories
                Original Research

                mindfulness,smoking,cancer,medical group visits,health disparities

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