ASPO Abstracts
Reaching Cancer Center Patients Who Smoke with Tobacco Treatment Integrated into Clinical Cancer Care: Examining the Reach and Effectiveness of Tobacco Treatment Programs Implemented in the NCI Cancer Center Cessation Initiative
Category: Behavioral Science & Health Communication
Conference Year: 2020
Abstract Body:
Purpose: Tobacco cessation among cancer patients results in improved cancer outcomes, yet cessation services are often unavailable in clinical oncology settings. Utilizing common metrics, we report on the reach and effectiveness of the tobacco treatment programs implemented in NCI-Designated Cancer Centers as part of the National Cancer Institute Cancer Center Cessation Initiative (C3I). Methods: Cancer Centers (n=34 Cancer Centers/affiliated settings) reported on tobacco use screening rates and current smoking prevalence over a 6-month period. Reach (percent of adult smokers receiving cessation counseling, medications, or connections to a quitline) was calculated for 29 Centers/affiliated settings overall and by type of tobacco treatment services delivered over a 6-month period. Thirty-day point prevalence smoking abstinence at 6-months post-engagement was measured among program participants at 12 Centers/affiliated settings. Results: Between 35.0%-100.0% (median 95.5%) of adult patients were screened for tobacco use over six months. Average current smoking prevalence was 12.5% (range 5.0% to 35.0%). All but one Center connected smokers with treatment using an optional or automatic eReferral via the electronic health record (EHR). The EHR revealed that over 6-months, a total of 7,557 smokers were reached with at least one type of evidence-based tobacco treatment out of 38,586 smokers identified, with reach ranging from 3.4%-83.7% (median=20.1%) across settings. In-person counseling was delivered to 12.4% of smokers on average, and an average of 14.4% of smokers received counseling via telephone. On average, 12.1% of smokers received/were prescribed cessation medications, while 4.9% of smokers were connected to state quitlines. Average 30-day abstinence rates were 11.6% (median=7.6%). Conclusions: Screening rates were high, and eReferrals were used at nearly all Centers to facilitate treatment delivery. Smokers were reached most often by internal counseling programs, both in person and telephone based; fewer were connected to state quitlines. Implementing population-based tobacco dependence treatment programs in oncology settings can reach large numbers of cancer patients who smoke, and may lead to improved cessation and treatment outcomes.
Keywords: cancer centers, tobacco treatment, implementation