Real-world comparison of phone versus video consultation in a tobacco treatment program during the COVID-19 pandemic

Objective

In addition to increased morbidity and mortality, continued smoking after a cancer diagnosis results in the added risks of cancer recurrence, adverse side effects, and decreased effectiveness of first line treatments. Combining counseling and U.S. Food and Drug Administration–approved pharmacotherapy is best practice in the treatment of tobacco use disorder (TUD). The COVID-19 pandemic ushered in a dramatic shift toward provision of care through telehealth platforms. We examined whether providing an initial consultation by phone versus video impacted the efficacy of tobacco treatment and to identify patients likely to choose these modalities.

Methods

In response to the pandemic, MD Anderson Cancer Center's Tobacco Research and Treatment Program (TRTP) shifted 100 % of its services to fully remote telehealth platforms. Because requirements for a face-to-face visit were suspended by the Texas state government during the pandemic, we were able to provide the initial consultation by phone or video. Data were collected from 5/1/2020 through 4/30/2021 for patients enrolled in the comprehensive program of the TRTP. Patients selected the telehealth modality they were most comfortable with. Abstinence rates at 3, 6, and 9 months and treatment engagement, defined as total number of counseling sessions attended, were compared between the groups with phone versus video consultations.

Results

Abstinence rates at 3, 6, and 9 months and treatment engagement were similar in the phone (N = 504) and video (N = 284) groups. Patients in the phone group were more likely to be White and older.

Conclusion

Initial consultation via phone versus video did not affect patients’ ability to achieve abstinence during subsequent phone-based tobacco treatment and did not affect patients’ engagement.

Practice Implications

These results establish the efficacy of phone-delivered tobacco treatment, including the provision of medication for patients with cancer, and can inform policy regarding requirements for such care after the pandemic.