Using a statewide collaborative approach to improve tobacco cessation referral rates for cancer patients.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 74-74
Author(s):  
Jane Alcyne Severson ◽  
Hilary Baca ◽  
Douglas W. Blayney ◽  
Karen Brown ◽  
Grayce Galiyas ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Scientific Evidence ◽  
Demonstration Project ◽  
Second Primary ◽  
Root Cause ◽  
Use Of Data ◽  
Lean Tools ◽  
Oncology Practice

74 Background: Tobacco use by cancer patients decreases the effectiveness of cancer treatment, increases treatment toxicity, increases the risk of developing a second primary cancer, and increases mortality. Stopping tobacco use may reduce many of these adverse effects in cancer patients. Methods: The Michigan Oncology Quality Consortium (MOQC) collaborated with the Michigan Cancer Consortium (MCC) to implement the Tobacco Cessation Demonstration Project. This entailed designing a standard workflow and other lean tools to assist oncology practices in referring all cancer patients who use tobacco to the free Michigan Tobacco QuitLine or other cessation services. 19 practices participated in three learning sessions during which the following were provided: education by subject matter experts, use of data management and lean tools, and the sharing of barriers and successes. Results: Examination of baseline MOQC Quality Oncology Practice Initiative (QOPI) data demonstrated that < 47% of patients who use tobacco were advised to quit or referred for tobacco cessation (n = 574 charts/44 sites), which was equivalent to the national QOPI mean in Fall 2012. Root cause analysis of this lack of action in tobacco cessation identified limited knowledge to the risks of continued smoking and the lack of available resources as barriers to adopting necessary change. Implementation of the MOQC/MCC Tobacco Cessation Demonstration Project increased total statewide referrals to the QuitLine by 30.9% over the first 2 months with an increasing proportion of patients (41%) being cancer patients referred by MOQC participating sites. Conclusions: Supplying scientific evidence, collaboration, and the use of lean tools improved the referral rate to a tobacco cessation program for oncology patients. [Table: see text]

scholarly journals A Collaborative Model for Facilitating the Delivery of Smoking Cessation Treatments to Cancer Patients: Results From Three Oncology Practices in South Carolina

2018 ◽  
Vol 14 (2) ◽  
pp. 112-124
Author(s):  
Daniel J. Kilpatrick ◽  
Kathleen B. Cartmell ◽  
Abdoulaye Diedhiou ◽  
K. Michael Cummings ◽  
Graham W. Warren ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
South Carolina ◽  
Quality Improvement ◽  
Collaborative Learning ◽  
Cancer Patients ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Cancer Centers

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.

Tobacco and Lung Cancer: Risks, Trends, and Outcomes in Patients with Cancer

2013 ◽  
pp. 359-364 ◽  
Author(s):  
Graham W. Warren ◽  
K. Michael Cummings
Keyword(s):  
Lung Cancer ◽  
Tobacco Use ◽  
Cancer Mortality ◽  
Tobacco Cessation ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Second Primary ◽  
Cancer Risks ◽  
Patients With Cancer ◽  
Increased Risk

Tobacco use, primarily associated with cigarette smoking, is the largest preventable cause of cancer mortality, responsible for approximately one-third of all cancer deaths. Approximately 85% of lung cancers result from smoking, with an additional fraction caused by secondhand smoke exposure in nonsmokers. The risk of lung cancer is dose dependent, but can be dramatically reduced with tobacco cessation, especially if the person discontinues smoking early in life. The increase in lung cancer incidence in different countries around in the world parallels changes in cigarette consumption. Lung cancer risks are not reduced by switching to filters or low-tar/low-nicotine cigarettes. In patients with cancer, continued tobacco use after diagnosis is associated with poor therapeutic outcomes including increased treatment-related toxicity, increased risk of second primary cancer, decreased quality of life, and decreased survival. Tobacco cessation in patients with cancer may improve cancer treatment outcomes, but cessation support is often not provided by oncologists. Reducing the health related effects of tobacco requires coordinated efforts to reduce exposure to tobacco, accurately assess tobacco use in clinical settings, and increase access to tobacco cessation support. Lung cancer screening and coordinated international tobacco control efforts offer the promise to dramatically reduce lung cancer mortality in the coming decades.

Evaluation of a dedicated institutional tobacco cessation service for thoracic clinic cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1603-1603
Author(s):  
Katharine Ann Dobson Amato ◽  
Michael Zevon ◽  
Pat Hysert ◽  
Robert Hysert ◽  
Stephanie Segal ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Participation Rate ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Therapeutic Outcomes ◽  
High Risk Cancer ◽  
First Contact

1603 Background: Tobacco use by cancer patients is associated with poor therapeutic outcomes including increased toxicity, decreased quality of life, and decreased survival. Though recommendations provide for tobacco assessment and cessation for cancer patients, few oncologists provide cessation support. Presented are data from universal tobacco assessment and cessation program for patients presenting at a thoracic oncology clinic in a NCI Designated Comprehensive Cancer Center. Methods: A standard set of evidence based tobacco assessment questions were incorporated into an automated electronic medical record based system delivered by nursing at initial consult and at follow-up. Patients eligible for tobacco cessation support (i.e. patients self-reporting tobacco use within 30 days) were automatically referred to a dedicated tobacco cessation service. All referred patients are sent a standardized packet of cessation materials with telephone-based follow-up by trained cessation counselors. Results: A total of 980 new thoracic clinic patients were referred to the cessation service from January 2011 and October 2012. Two-thirds of the patients referred (n=728) referred into the system were current smokers and the remainder had quit in the 30 days prior to assessment. Among the 788 patients with contact attempts by the cessation service, 81.2% (n=640) were successfully contacted and only 2.5% (n=20) refused the offer of cessation support. At first contact, 75.6% (n=484) of patients reported continued current tobacco use. Follow-up calls were placed for 53.1% (n=340) of those who participated in the first contact an average of 39 days after the first successful contact. The follow-up had a 93.2% (n=317) participation rate which revealed that 33.3% (n=106) reported not smoking, an 8.9% increase since the first cessation service telephone call. Conclusions: Data demonstrate that an automated tobacco assessment and cessation service for thoracic oncology patients can effectively generate a large mandatory referral base with high patient interest in cessation, and that cessation support can be implemented and maintained in high risk cancer patients.

scholarly journals Impact of Family and Social Network on Tobacco Cessation Amongst Cancer Patients

2021 ◽  
Vol 28 ◽  
pp. 107327482110566
Author(s):  
Melissa Neumann ◽  
Neal Murphy ◽  
Nagashree Seetharamu
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Tobacco Cessation ◽  
Family Members ◽  
Second Primary ◽  
Entire Family ◽  
Second Primary Cancers ◽  
Diagnosis Of Cancer

Continued smoking after a cancer diagnosis adversely affects outcomes, including recurrence of the primary cancer and/or the development of second primary cancers. Despite this, prevalence of smoking is high in cancer survivors and higher in survivors of tobacco-related cancers. The diagnosis of cancer provides a teachable moment, and social networks, such as family, friends, and social groups, seem to play a significant role in smoking habits of cancer patients. Interventions that involve members of patients’ social network, especially those who also smoke, might improve tobacco cessation rates. Very few studies have been conducted to evaluate and target patients’ social networks. Yet, many studies have demonstrated that cancer survivors who received higher levels of social support were less likely to be current smokers. Clinicians should be doing as much as they can to encourage smoking cessation in both patients and relevant family members. Research aimed at influencing smoking behavioral change in the entire family is needed to increase cessation intervention success rate, which can ultimately improve the health and longevity of patients as well as their family members.

Increasing access to tobacco cessation support for cancer patients: Results of an institution-wide screening and referral program in an NCI-designated comprehensive cancer center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1566-1566
Author(s):  
Mary E. Reid ◽  
Katharine Dobson Amato ◽  
Michael Zevon ◽  
Robert Reed ◽  
Pat Hysert ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Initial Contact ◽  
Full Time ◽  
National Organizations ◽  
Phone Contact

1566 Background: Guidelines from ASCO and other national organizations recommend assessment of tobacco use and structured tobacco cessation support for cancer patients. However, most oncology providers fail to provide cessation assistance to cancer patients who use tobacco. Reported are results of a systematic approach to assessing tobacco use and delivering cessation support for cancer patients in a comprehensive cancer center. Methods: A standard set of evidence based tobacco assessment questions were incorporated into an automated electronic medical record based system delivered by nursing at initial consult and follow-up. Patients eligible for tobacco cessation support (i.e. patients self-reporting tobacco use within 30 days) were automatically referred to a dedicated tobacco cessation service providing primarily phone based cessation support. Results: Of approximately 11,900 patients screened over 26 months, 2,978 patients were automatically triaged for cessation support. Contact priority was given to newly diagnosed patients in tobacco related disease sites. Using 1.25 full time cessation specialists, 1,531 received only a standard tobacco cessation mailing and no further contacts were attempted by the cessation service. In 1447 patients with attempted phone contact by the cessation service, 1189 (82.2%) were reached within 5 contact attempts. In 1,189 patients contacted, 52 (4.4%) were inappropriate referrals, 245 (20.6%) were in an active quitting phase, 465 (39.1%) were willing to prepare, and only 24 (2.0%) refused any intervention at initial contact. At the most recent follow-up, 44 patients (3.7%) requested no further contact and 90 additional patients (7.6%) were lost to follow-up. In the 1,045 remaining patients, 338 (32.3%) reported quitting tobacco use. Notably, in the 1,531 patients with no phone contact by the cessation service, only 14 proactively contacted the cessation service for assistance. Conclusions: An institution wide program to automate the delivery of tobacco cessation services was feasible with high patient contact rates, low patient refusal, and moderately high tobacco cessation rates.

Addressing tobacco use and cessation in cancer patients: Practices, perceptions, and barriers reported by oncology providers.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1561-1561 ◽  
Author(s):  
Graham Walter Warren ◽  
James Roger Marshall ◽  
K. Michael Cummings ◽  
Benjamin A Toll ◽  
Ellen R. Gritz ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
International Association ◽  
Clinical Care ◽  
Adverse Outcomes ◽  
Cancer Outcomes ◽  
Standard Part ◽  
American Society ◽  
Oncology Providers

1561 Background: Tobacco use is associated with adverse outcomes in cancer patients, but there are limited data on tobacco cessation support by oncology providers. Methods: Duplicate surveys were sent to the membership of the International Association for the Study of Lung Cancer (IASLC) and the American Society of Clinical Oncology (ASCO) asking about tobacco assessment and cessation practices, perceptions of tobacco use by cancer patients, and barriers to implementing tobacco cessation. The results of 1,507 responses from IASLC and 1,197 responses from ASCO are reported. Results: At initial consult, most respondents asked about tobacco use (90% in both surveys), asked if smokers would quit tobacco use (79-80%), advised patients to stop smoking (81-82%). Most respondents felt that tobacco affects cancer outcomes (87-92%) and that tobacco cessation should be a standard part of clinical care (86-90%). However, few discussed medication options (40-44%) or actively provided smoking cessation assistance (39% in both surveys). Fewer respondents asked about tobacco use at follow-up and few reported adequate tobacco cessation training (29-33%). Dominant barriers to providing cessation interventions included patient resistance to cessation treatment (67-74%) and inability to get patients to quit tobacco use (58-72%), but very few believed tobacco cessation was a waste of time (8-12%). Lack of time, reimbursement, lack of training, and lack of resources were reported as barriers in less than 50% of respondents. Conclusions: Oncology providers feel tobacco affects cancer outcomes and cessation should be a standard part of clinical care. Most assess tobacco use, but few discuss medication options or provide active cessation support. Efforts are needed to improve cessation methods in cancer patients and to improve access to tobacco cessation support for cancer patients.

scholarly journals Can Cancer Diagnosis Help in Quitting Tobacco? Barriers and Enablers to Tobacco Cessation Among Head and Neck Cancer Patients from a Tertiary Cancer Center in South india

2020 ◽  
Vol 42 (4) ◽  
pp. 346-352
Author(s):  
Bincy Mathew ◽  
E. Vidhubala ◽  
Arvind Krishnamurthy ◽  
C. Sundaramoorthy
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Tobacco Use ◽  
Neck Cancer ◽  
Tobacco Cessation ◽  
Cancer Center ◽  
Potential Threat ◽  
Diagnosis Of Cancer ◽  
Readiness To Quit

Background: Tobacco use contributes to almost 40% of the cancers in India. Considering the potential threat, many preventive measures have been instigated in the country. However, tobacco cessation for hospitalized cancer patients is an unexplored territory in India. This study aims to understand the quit status and to explore the reasons to quit or continue the use of tobacco after the diagnosis of head and neck cancer (HNC). Methods: HNC patients admitted between February and April 2016 were assessed for their tobacco use status. A DT was used to assess the psychological distress. Users were assessed for their readiness to quit and dependence on tobacco. An in-depth interview was conducted among 25 patients (seven current users and 18 recent quitters), and themes that emerged were discussed. Results: Of the 119 HNC patients, 71 were tobacco users and 48 had quit tobacco after the diagnosis. The reasons to quit were the perceived benefits of quitting, advice from the physicians, and awareness about cancer and its association with tobacco. In contrast, the reasons to continue the use of tobacco were attributed to coping mechanisms, nihilistic perception about the outcome of the cancer, and a lack of understanding about cancer and its association with tobacco. Conclusion: The recent quitters comprehended the benefits of quitting and were able to prioritize their needs after the diagnosis. However, one-third of the HNC patients continued to use tobacco even after the diagnosis of cancer. Hence, tobacco cessation services need to be integrated into oncology services for achieving better treatment outcomes.

EFFECTS OF SMOKING ON THE DISEASE PROGNOSIS IN CANCER PATIENTS

2019 ◽  
Vol 65 (3) ◽  
pp. 321-329
Author(s):  
David Zaridze ◽  
Anush Mukeriya
Keyword(s):  
Smoking Cessation ◽  
Cancer Patients ◽  
Malignant Tumors ◽  
Scientific Data ◽  
Second Primary ◽  
Primary Tumors ◽  
Smoking Intensity ◽  
Risk Of Death ◽  
Disease Prognosis ◽  
Increased Risk

Smoking not only increases the risk of the development of malignant tumors (MT), but affects the disease prognosis, mortality and survivability of cancer patients. The link between the smoking of cancer patients and increased risk of death by all diseases and oncological causes has been established. Mortality increases with the growth of the smoking intensity, i.e. the number of cigarettes, smoked per day. Smoking is associated with the worst general and oncological survivability. The statistically trend-line between the smoking intensity and survivability was observed: each additional unit of cigarette consumption (pack/year) leads to the Overall Survival Reduction by 1% (p = 0.002). The link between smoking and the risk of developing second primary tumors has been confirmed. Smoking increases the likelihood of side effects of the antitumor therapy both drug therapy and radiation therapy and reduces the treatment efficacy. The smoking cessation leads to a significant improvement in the prognosis of a cancer patient. Scientific data on the negative effect of smoking on the prognosis of cancer patients have a major clinical importance. The treatment program for cancer patients should include science-based methods for the smoking cessation. The latter is fundamentally important, taking into account that the smoking frequency among cancer patients is much higher than in the population.

Overestimated risk of second primary malignancies in ovarian cancer patients

2000 ◽  
Vol 36 (1) ◽  
pp. 100-105 ◽  
Author(s):  
K. Bergfeldt ◽  
C. Silfverswärd ◽  
S. Einhorn ◽  
P. Hall
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Second Primary ◽  
Second Primary Malignancies

scholarly journals Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Hospital Treatment ◽  
Management Support ◽  
Tobacco Use Cessation ◽  
Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

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