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.
Document Type
Article
Publication Date
2-1-2024
Digital Object Identifier (DOI)
https://doi.org/10.1200/OP.23.00393
Funding Information
Supported by P30 CA008748, P30 CA013696, P30 CA138313, P30 CA177558, and OISE-20-66590-1.
Repository Citation
Ostroff, Jamie S.; Reilly, Eileen M.; Burris, Jessica L.; Warren, Graham W.; Shelton, Rachel C.; Mullett, Timothy W.; and Just ASK Quality Improvement Task Force, "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." (2024). Psychology Faculty Publications. 217.
https://uknowledge.uky.edu/psychology_facpub/217
Notes/Citation Information
© 2023 by American Society of Clinical Oncology