Current Practices, Perceived Barriers, and Promising Implementation Strategies for Improving Quality of Smoking Cessation Support in Accredited Cancer Programs of the American College of Surgeons
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Published:2023-11-15
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ISSN:2688-1527
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Container-title:JCO Oncology Practice
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language:en
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Short-container-title:JCO Oncology Practice
Author:
Ostroff Jamie S.1ORCID, Reilly Eileen M.2ORCID, Burris Jessica L.3ORCID, Warren Graham W.4ORCID, Shelton Rachel C.5ORCID, Mullett Timothy W.6ORCID, Adsit Rob, Allison Lisa, Boffa Daniel, Burris Jessica, Carter Asa, Darville Audrey, Fiore Michael, Hahn Ellen, Harris James, Kirstein Laurie, McCarthy Danielle, Mullett Timothy, Nelson Heidi, Ostroff Jamie, Reilly Eileen, Reuter Erin, Shafir Sarah, Shelton Rachel, Tong Elisa, Warren Graham,
Affiliation:
1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 2. American College of Surgeons, Chicago, IL 3. Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY 4. Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 5. Department of Sociomedical Sciences, Columbia University, New York, NY 6. Department of Surgery, College of Medicine, University of Kentucky, Lexington, KY
Abstract
PURPOSE Persistent smoking is associated with poor outcomes in cancer care. It is strongly recommended that oncology care providers provide cessation support; however, there is limited information about smoking cessation assessment and treatment patterns in routine oncology practice. METHODS Leaders of the American College of Surgeons Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (National Accredited Program for Breast Cancer) elected to participate in a national quality improvement initiative (Just ASK) focused on smoking assessment/treatment in cancer care. Online baseline survey responses were received from 762 accredited programs. RESULTS Most programs reported regularly asking about smoking (89.9%), documenting smoking history and current use (85.8%), and advising patients to quit (71.2%). However, less than half of programs reported documenting a smoking cessation treatment plan (41.7%). Even fewer programs reported regularly assisting patients with quitting (41.3%), providing self-help information (27.2%), providing individual counseling (18.2%), and referring patients to an affiliated tobacco treatment program (26.1%) or external Quitline (28.5%). Very few programs reported regularly prescribing medications (17.6%). Principal barriers to tobacco treatment delivery were lack of staff training (68.8%), lack of designated specialists (61.9%), perceived patient resistance (58.3%), lack of available resources (53.3%), competing clinical priorities (50.9%), inadequate program funding (40.6%), insufficient staff time (42.4%), and inadequate reimbursement (31.0%). CONCLUSION Although programs reported a high rate of smoking assessment, critical gaps in advising and assisting patients with cessation were found. Improving equitable delivery of smoking assessment/treatment in cancer care will require addressing key organizational and provider barriers for implementation of best practices.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Oncology (nursing),Health Policy,Oncology
Reference33 articles.
1. Warren GW, Simmons VN: Tobacco Use and the Cancer Patient. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology (ed 12). Baltimore, MD, Lippincott Williams & Wilkins, 2023, pp 30-42 2. Attributable Failure of First-line Cancer Treatment and Incremental Costs Associated With Smoking by Patients With Cancer 3. US Department of Health and Human Services: The Health Consequences of Smoking–50 Years of Progress: A Report of the Surgeon General. Atlanta, GA, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 4. Assessment of Trends in Cigarette Smoking Cessation After Cancer Diagnosis Among US Adults, 2000 to 2017
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