Date Available


Year of Publication


Degree Name

Master of Science (MS)

Document Type

Master's Thesis


Arts and Sciences



First Advisor

Dr. Jessica L. Burris


Smoking after cancer diagnosis is linked to cancer-specific and all-cause mortality among other adverse outcomes. Yet, 10-20% of U.S. cancer survivors are current smokers. Implementation of evidence-based tobacco treatment in cancer care facilities is widely recommended, yet rarely accomplished. This study focuses on the early outcomes of a tobacco treatment program integrated within an NCI-designated cancer center. Participants consist of 26,365 patients seen at the cancer center during the first 18 months of implementation. The study is a retrospective chart review of patients’ tobacco use, and among current users, patients’ treatment referral response. Over 99% of patients were screened for tobacco use. Current use occurred in 21.05% of patients; cigarettes were the most popular product. Only 17.22% of current users accepted a referral for tobacco treatment; among the 76.59% of current users who declined, the majority were “not ready to quit” or wanted to quit “on their own”. Multiple demographic and clinical variables were associated with tobacco use and treatment referral response outcomes. Despite cancer diagnosis presenting a “teachable moment” for tobacco cessation, many cancer patients may not be ready to quit. Clinically proven strategies to increase motivation, prompt quit attempts and encourage treatment use are warranted in cancer settings.

Digital Object Identifier (DOI)