TY - JOUR
T1 - Integrating Tobacco Treatment Into Oncology Care
T2 - Reach and Effectiveness of Evidence-Based Tobacco Treatment Across National Cancer Institute-Designated Cancer Centers
AU - Hohl, Sarah D.
AU - Matulewicz, Richard S.
AU - Salloum, Ramzi G.
AU - Ostroff, Jamie S.
AU - Baker, Timothy B.
AU - Schnoll, Robert
AU - Warren, Graham
AU - Bernstein, Steven L.
AU - Minion, Mara
AU - Lenhoff, Katie
AU - Dahl, Neely
AU - Juon, Hee Soon
AU - Tsosie, Ursula
AU - Fleisher, Linda
AU - D'Angelo, Heather
AU - Ramsey, Alex T.
AU - Ashing, Kimlin T.
AU - Rolland, Betsy
AU - Nolan, Margaret B.
AU - Bird, Jennifer E.
AU - Nguyen, Claire V.T.
AU - Pauk, Danielle
AU - Adsit, Robert T.
AU - Tindle, Hilary A.
AU - Shoenbill, Kimberly
AU - Yeung, Sophia
AU - Presant, Cary A.
AU - Wiseman, Kara P.
AU - Wen, Kuang Yi
AU - Chichester, Lou Anne
AU - Chen, Li Shiun
N1 - Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2023/5/20
Y1 - 2023/5/20
N2 - PURPOSEQuitting smoking improves patients' clinical outcomes, yet smoking is not commonly addressed as part of cancer care. The Cancer Center Cessation Initiative (C3I) supports National Cancer Institute-designated cancer centers to integrate tobacco treatment programs (TTPs) into routine cancer care. C3I centers vary in size, implementation strategies used, and treatment approaches. We examined associations of these contextual factors with treatment reach and smoking cessation effectiveness.METHODSThis cross-sectional study used survey data from 28 C3I centers that reported tobacco treatment data during the first 6 months of 2021. Primary outcomes of interest were treatment reach (reach)-the proportion of patients identified as currently smoking who received at least one evidence-based tobacco treatment component (eg, counseling and pharmacotherapy)-and smoking cessation effectiveness (effectiveness)-the proportion of patients reporting 7-day point prevalence abstinence at 6-month follow-up. Center-level differences in reach and effectiveness were examined by center characteristics, implementation strategies, and tobacco treatment components.RESULTSOf the total 692,662 unique patients seen, 44,437 reported current smoking. Across centers, a median of 96% of patients were screened for tobacco use, median smoking prevalence was 7.4%, median reach was 15.4%, and median effectiveness was 18.4%. Center-level characteristics associated with higher reach included higher smoking prevalence, use of center-wide TTP, and lower patient-to-tobacco treatment specialist ratio. Higher effectiveness was observed at centers that served a larger overall population and population of patients who smoke, reported a higher smoking prevalence, and/or offered electronic health record referrals via a closed-loop system.CONCLUSIONWhole-center TTP implementation among inpatients and outpatients, and increasing staff-to-patient ratios may improve TTP reach. Designating personnel with tobacco treatment expertise and resources to increase tobacco treatment dose or intensity may improve smoking cessation effectiveness.
AB - PURPOSEQuitting smoking improves patients' clinical outcomes, yet smoking is not commonly addressed as part of cancer care. The Cancer Center Cessation Initiative (C3I) supports National Cancer Institute-designated cancer centers to integrate tobacco treatment programs (TTPs) into routine cancer care. C3I centers vary in size, implementation strategies used, and treatment approaches. We examined associations of these contextual factors with treatment reach and smoking cessation effectiveness.METHODSThis cross-sectional study used survey data from 28 C3I centers that reported tobacco treatment data during the first 6 months of 2021. Primary outcomes of interest were treatment reach (reach)-the proportion of patients identified as currently smoking who received at least one evidence-based tobacco treatment component (eg, counseling and pharmacotherapy)-and smoking cessation effectiveness (effectiveness)-the proportion of patients reporting 7-day point prevalence abstinence at 6-month follow-up. Center-level differences in reach and effectiveness were examined by center characteristics, implementation strategies, and tobacco treatment components.RESULTSOf the total 692,662 unique patients seen, 44,437 reported current smoking. Across centers, a median of 96% of patients were screened for tobacco use, median smoking prevalence was 7.4%, median reach was 15.4%, and median effectiveness was 18.4%. Center-level characteristics associated with higher reach included higher smoking prevalence, use of center-wide TTP, and lower patient-to-tobacco treatment specialist ratio. Higher effectiveness was observed at centers that served a larger overall population and population of patients who smoke, reported a higher smoking prevalence, and/or offered electronic health record referrals via a closed-loop system.CONCLUSIONWhole-center TTP implementation among inpatients and outpatients, and increasing staff-to-patient ratios may improve TTP reach. Designating personnel with tobacco treatment expertise and resources to increase tobacco treatment dose or intensity may improve smoking cessation effectiveness.
KW - Cross-Sectional Studies
KW - Humans
KW - National Cancer Institute (U.S.)
KW - Neoplasms/epidemiology
KW - Nicotiana
KW - Smoking Cessation/psychology
KW - Tobacco Use
KW - United States/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85148941678&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:001003976600016&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1200/JCO.22.00936
DO - 10.1200/JCO.22.00936
M3 - Article
C2 - 36473135
SN - 0732-183X
VL - 41
SP - 2756
EP - 2766
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 15
ER -
