Implementing smoking cessation within cancer treatment centres and potential economic impacts

Evans, William K.; Truscott, Rebecca; Cameron, Erin; Rana, Sargam; Isaranuwatchai, Wanrudee; Haque, M.; Rabeneck, Linda

doi:10.21037/tlcr.2019.05.09

Cited by 18 publications

(29 citation statements)

References 17 publications

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“…Realist evaluations begin with a program theory. OH-CCO’s requirement for RCCs to implement SC interventions was based on substantial evidence that SC has significant benefits to individuals that have cancer, as well as to the health system [ 21 ]. OH-CCO allowed RCCs to be flexible in their approach, in hopes that tailoring the intervention would produce successful results in each context.…”

Section: Methodsmentioning

confidence: 99%

Identifying Best Implementation Practices for Smoking Cessation in Complex Cancer Settings

et al. 2021

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Background: In response to evidence about the health benefits of smoking cessation at time of cancer diagnosis, Ontario Health (Cancer Care Ontario) (OH-CCO) instructed Regional Cancer Centres (RCC) to implement smoking cessation interventions (SCI). RCCs were given flexibility to implement SCIs according to their context but were required to screen new patients for tobacco status, advise patients about the importance of quitting, and refer patients to cessation supports. The purpose of this evaluation was to identify practices that influenced successful implementation across RCCs. Methods: A realist evaluation approach was employed. Realist evaluations examine how underlying processes of an intervention (mechanisms) in specific settings (contexts) interact to produce results (outcomes). A realist evaluation may thus help to generate an understanding of what may or may not work across contexts. Results: The RCCs with the highest Tobacco Screening Rates used a centralized system. Regarding the process for advising and referring, three RCCs offered robust smoking cessation training, resulting in advice and referral rates between 80% and 100%. Five RCCs surpassed the target for Accepted Referral Rates; acceptance rates for internal referral were highest overall. Conclusion: Findings highlight factors that may influence successful SCI implementation.

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Section: Methodsmentioning

confidence: 99%

Identifying Best Implementation Practices for Smoking Cessation in Complex Cancer Settings

et al. 2021

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“…In response to the US Surgeon General’s 2014 report [ 17 ], the US National Comprehensive Cancer Network produced the Clinical Practice Guidelines in Oncology for Smoking Cessation [ 18 ]. It is widely recognised that evidence-based quality cancer care includes addressing tobacco use [ 19 , 20 ], and there is a strong rationale for all cancer patients to be screened for their smoking status, advised of the health benefits of cessation and provided with help to quit [ 21 ]. Additionally, high smoking relapse rates and the mis-reporting of smoking status in the oncology setting [ 22 ] indicate the need to provide such support to those who report recently quitting smoking as well as those who report being current smokers.…”

Section: Introductionmentioning

confidence: 99%

“…The dominant barriers to delivering cessation care to people with cancer are lack of time, expertise and resources [ 28 ]. There has been little research conducted into addressing these barriers with effective systematic implementation of smoking cessation care in cancer centres [ 21 ]. In order for the potential benefits of smoking cessation for people with cancer to be realised, there is a need to identify models of implementation of best practice smoking cessation care in cancer settings.…”

Section: Introductionmentioning

confidence: 99%

Care to Quit: a stepped wedge cluster randomised controlled trial to implement best practice smoking cessation care in cancer centres

et al. 2021

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Background Cigarette smoking in people with cancer is associated with negative treatment-related outcomes including increased treatment toxicity and complications, medication side effects, decreased performance status and morbidity. Evidence-based smoking cessation care is not routinely provided to patients with cancer. The purpose of this study is to determine the effectiveness of a smoking cessation implementation intervention on abstinence from smoking in people diagnosed with cancer. Methods A stepped wedge cluster randomised design will be used. All sites begin in the control condition providing treatment as usual. In a randomly generated order, sites will move to the intervention condition. Based on the Theoretical Domains Framework, implementation of Care to Quit will include (i) building the capability and motivation of a critical mass of key clinical staff and identifying champions; and (ii) identifying and implementing cessation care models/pathways. Two thousand one hundred sixty patients with cancer (diagnosed in the prior six months), aged 18+, who report recent combustible tobacco use (past 90 days or in the 30 days prior to cancer diagnosis) and are accessing anti-cancer therapy, will be recruited at nine sites. Assessments will be conducted at baseline and 7-month follow-up. The primary outcome will be 6-month abstinence from smoking. Secondary outcomes include biochemical verification of abstinence from smoking, duration of quit attempts, tobacco consumption, nicotine dependence, provision and receipt of smoking cessation care, mental health and quality of life and cost effectiveness of the intervention. Discussion This study will implement best practice smoking cessation care in cancer centres and has the potential for wide dissemination. Trial registration The trial is registered with ANZCTR (www.anzctr.org.au): ACTRN (ACTRN12621000154808) prior to the accrual of the first participant and will be updated regularly as per registry guidelines.

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“…The dominant barriers to delivering cessation care to people with cancer are lack of time, expertise and resources (28). There has been little research conducted into addressing these barriers with effective systematic implementation of smoking cessation care in cancer centres (21). In order for the potential bene ts of smoking cessation for people with cancer to be realised, there is a need to identify models of implementation of best practice smoking cessation care in cancer settings.…”

Section: Introductionmentioning

confidence: 99%

“…In response to the US Surgeon General's 2014 report (17), the US National Comprehensive Cancer Network produced the Clinical Practice Guidelines in Oncology for Smoking Cessation (18). It is widely recognised that evidence-based quality cancer care includes addressing tobacco use (19,20), and there is a strong rationale for all cancer patients to be screened for their smoking status, advised of the health bene ts of cessation and provided with help to quit (21). Additionally, high smoking relapse rates and the mis-reporting of smoking status in the oncology setting (22) indicate the need to provide such support to those who report recently quitting smoking as well as those who report being current smokers.…”

Section: Introductionmentioning

confidence: 99%

Care to Quit: A Stepped Wedge Cluster Randomised Controlled Trial to Implement Best Practice Smoking Cessation Care in Cancer Centres

Paul¹,

Warren

Vinod

et al. 2020

Preprint

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BackgroundCigarette smoking in people with cancer is associated with negative treatment related outcomes including increased treatment toxicity and complications, medication side effects, decreased performance status and morbidity. Evidence based smoking cessation care is not routinely provided to patients with cancer. The purpose of this study is to determine the effectiveness of a smoking cessation implementation intervention on abstinence from smoking in people diagnosed with cancer.MethodsA stepped wedge cluster randomized design will be used. All sites begin in the control condition providing treatment as usual. In a randomly generated order, sites will move to the intervention condition. Based on the Theoretical Domains Framework, implementation of Care to Quit will include i) building the capability and motivation of a critical mass of key clinical staff and identifying champions; and ii) identifying and implementing cessation care models/pathways. 2160 patients with cancer (diagnosed in the prior six months), aged 18+, who report recent combustible tobacco use (past 90 days or in the 30 days prior to cancer diagnosis) and are accessing anti-cancer therapy, will be recruited at nine sites. Assessments will be conducted at baseline and 7-month follow-up. The primary outcome will be 6-month abstinence from smoking. Secondary outcomes include biochemical verification of abstinence from smoking, duration of quit attempts, tobacco consumption, nicotine dependence, variables, provision and receipt of smoking cessation care, mental health and quality of life and cost effectiveness of the intervention. DiscussionThis study will implement best practice smoking cessation care in cancer centres and has the potential for wide dissemination. Trial registrationThe trial is registered with ANZCTR (www.anzctr.org.au): ACTRN (submitted, awaiting approval due to ANZCTR delays) prior to the accrual of the first participant and will be updated regularly as per registry guidelines.

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Implementing smoking cessation within cancer treatment centres and potential economic impacts

Cited by 18 publications

References 17 publications

Identifying Best Implementation Practices for Smoking Cessation in Complex Cancer Settings

Identifying Best Implementation Practices for Smoking Cessation in Complex Cancer Settings

Care to Quit: a stepped wedge cluster randomised controlled trial to implement best practice smoking cessation care in cancer centres

Care to Quit: A Stepped Wedge Cluster Randomised Controlled Trial to Implement Best Practice Smoking Cessation Care in Cancer Centres

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