Journal article
Time to put it out – nurse-facilitated tobacco treatment in a comprehensive cancer center
Translational behavioral medicine, Vol.11(9), pp.1726-1738
08/04/2021
DOI: 10.1093/tbm/ibab073
PMCID: PMC8529899
PMID: 34347876
Abstract
Few cancer patients receive guideline-concordant care for treatment of tobacco
dependence. The purpose of this pilot trial was to obtain preliminary estimates
of effectiveness of an evidence-based practice intervention on the delivery of
tobacco treatment and cessation outcomes in cancer patients. We conducted a
pragmatic implementation trial with a before-after design in 119 current or
recently quit adult smokers with cancer who met with a clinician at a single
National Cancer Institute designated comprehensive cancer center (CCC)
(
n
= 61 pre-implementation,
n
= 58
post-implementation). We used a multi-component strategy based on the Chronic
Care Model to implement National Comprehensive Cancer Network (NCCN) guidelines
for smoking cessation. Smoking cessation counseling during the index visit was
assessed by exit interview and patients were interviewed by phone to assess
cessation outcomes at 3-month follow-up. Performance of cessation counseling and
7-day point prevalence abstinence (PPA) were compared across the pre- and
post-implementation periods using log-logistic regression, accounting for
clustering by nursing staff. More patients had received assistance in quitting
at the index visit during the post-implementation period compared to the
pre-implementation period (30 vs. 10%,
p
< .01). At
3-month follow-up, 38 and 14% of participants had discussed smoking cessation
medication with a CCC healthcare professional and 57 and 27% of participants had
used pharmacotherapy, respectively (
p
< .01 for both
comparisons). Seven-day PPA at 3-month follow-up was similar in both periods,
however (14 vs. 12%, respectively). A multi-component tobacco treatment
intervention increased the proportion of smokers who received assistance in
quitting smoking during usual cancer care but did not improve cessation
outcomes.
Few patients with cancer receive help in quitting smoking. We conducted a pilot
before-after trial to determine the effectiveness of an evidence-based practice
intervention, including brief cessation counseling during the clinic visit and
referral to an onsite tobacco treatment specialist, on the delivery of stop
smoking services and cessation outcomes at a NCI-designated Comprehensive Cancer
Center. During the post-implementation period, cancer patients who smoke were
more likely to have received assistance in quitting in clinic and during 3-month
follow-up. This change in process of care did not translate into improved
short-term abstinence from tobacco, however. Greater and more sustained
participation in tobacco treatment will be needed to improve cessation outcomes
in this population.
Details
- Title: Subtitle
- Time to put it out – nurse-facilitated tobacco treatment in a comprehensive cancer center
- Creators
- David A Katz - University of IowaSarah L Mott - University of Iowa Hospitals and ClinicsJane A Utech - University of Iowa Hospitals and ClinicsAutumn C Bahlmann - University of Iowa Hospitals and ClinicsKimberly A Dukes - University of IowaAaron T Seaman - University of IowaDouglas E Laux - University of IowaMuhammad Furqan - University of IowaZachary J Pollock - University of Iowa Hospitals and ClinicsMark W Vander Weg - , , , , , IA
- Resource Type
- Journal article
- Publication Details
- Translational behavioral medicine, Vol.11(9), pp.1726-1738
- DOI
- 10.1093/tbm/ibab073
- PMID
- 34347876
- PMCID
- PMC8529899
- NLM abbreviation
- Transl Behav Med
- ISSN
- 1869-6716
- eISSN
- 1613-9860
- Publisher
- Oxford University Press
- Grant note
- P30CA086862 / ;
- Language
- English
- Date published
- 08/04/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Psychological and Brain Sciences; Center for Social Science Innovation; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984359817002771
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