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Current Oncology
Special Issues
Smoking Cessation after a Cancer Diagnosis
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Smoking Cessation after a Cancer Diagnosis

A special issue of Current Oncology (ISSN 1718-7729).

Deadline for manuscript submissions: closed (15 February 2022) | Viewed by 36078

Special Issue Editors

Prof. emer. William K. Evans

E-Mail Website
Guest Editor
Department of Oncology, McMaster University c/o 352 Bay St South, Hamilton, Ontario L8P 3J9, Canada
Interests: smoking cessation; cost and cost-effectiveness; real-world evidence
Dr. Meredith Giuliani

E-Mail Website
Guest Editor
Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2C1, Canada
Interests: smoking cessation; health professions education; health equity
Dr. Lawson Eng

E-Mail Website
Guest Editor
Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario M5G 2C1, Canada
Interests: smoking cessation; cancer survivorship and supportive care; outcomes and health services research; population-level data

Special Issue Information

Dear Colleagues,

Achieving the best outcomes for cancer patients requires the delivery of sophisticated surgery, high-precision radiotherapy and an ever-expanding variety of systemic therapies often administered in combination. However, for each of these therapies to achieve their maximum benefit with the least possible toxicity, cancer patients who smoke will need help in quitting. Furthermore, advances in these therapies have led to a growing population of cancer survivors, including patients with metastatic disease, who would derive many non-cancer-related (e.g., cardiorespiratory) benefits if they quit smoking. There is still much to be learned about the interactions between tobacco smoke and the cancer therapies used by oncologists, particularly systemic therapies. This Special Issue will focus on what is currently known about the impact of smoking on each of the key cancer treatment modalities and underscore the need for more research on how continued smoking impacts the effectiveness of the different classes of new agents. Practical advice on how to help cancer patients quit and lessons learned by institutions and health systems that have tried to implement smoking cessation initiatives will provide guidance to health care providers seeking to deliver high-quality cancer care to their patients.

Prof. emer. William K. Evans
Dr. Meredith Giuliani
Dr. Lawson Eng
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • smoking cessation
  • surgery
  • radiation therapy
  • systemic therapy
  • quality care
  • implementing smoking cessation

Published Papers (15 papers)

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Research

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10 pages, 2051 KiB  
Article
Lessons from Cost-Effectiveness Analysis of Smoking Cessation Programs for Cancer Patients
by Jeffrey S. Hoch, Heather K. Barr, Andrea M. Guggenbickler and Carolyn S. Dewa
Curr. Oncol. 2022, 29(10), 6982-6991; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29100549 - 26 Sep 2022
Cited by 3 | Viewed by 1612
Abstract
Background: Smoking among patients diagnosed with cancer poses important health and financial challenges including reduced effectiveness of expensive cancer therapies. This study explores the value of smoking cessation programs (SCPs) for patients already diagnosed with cancer. It also identifies conditions under which SPCs [...] Read more.
Background: Smoking among patients diagnosed with cancer poses important health and financial challenges including reduced effectiveness of expensive cancer therapies. This study explores the value of smoking cessation programs (SCPs) for patients already diagnosed with cancer. It also identifies conditions under which SPCs may be wise investments. Methods: Using a simplified decision analytic model combined with insights from a literature review, we explored the cost-effectiveness of SCPs. Results: The findings provide insights about the potential impact of cessation probabilities among cancer patients in SCPs and the potential impact of SCPs on cancer patients’ lives. Conclusion: The evidence suggests that there is good reason to believe that SCPs are an economically attractive way to improve outcomes for cancer patients when SCPs are offered in conjunction with standard cancer care. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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10 pages, 2481 KiB  
Communication
Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England
by Sanjay Agrawal, Zaheer Mangera, Rachael L. Murray, Freya Howle and Matthew Evison
Curr. Oncol. 2022, 29(5), 3738-3747; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29050299 - 20 May 2022
Cited by 3 | Viewed by 2540
Abstract
There is a significant body of evidence that delivering tobacco dependency treatment within acute care hospitals can deliver high rates of tobacco abstinence and substantial benefits for both patients and the healthcare system. This evidence has driven a renewed investment in the UK [...] Read more.
There is a significant body of evidence that delivering tobacco dependency treatment within acute care hospitals can deliver high rates of tobacco abstinence and substantial benefits for both patients and the healthcare system. This evidence has driven a renewed investment in the UK healthcare service to ensure all patients admitted to hospital are provided with evidence-based interventions during admission and after discharge. An early-implementer of this new wave of hospital-based tobacco dependency treatment services is “the CURE project” in Greater Manchester, a region in the North West of England. The CURE project strives to change the culture of a hospital system, to medicalise tobacco dependency and empower front-line hospital staff to deliver an admission bundle of care, including identification of patients that smoke, provision of very brief advice (VBA), protocolised prescription of pharmacotherapy, and opt-out referral to the specialist CURE practitioners. This specialist team provides expert treatment and behaviour change support during the hospital admission and can agree a support package after discharge, with either hospital-led or community-led follow-up. The programme has shown exceptional clinical effectiveness, with 22% of all smokers admitted to hospital abstinent from tobacco at 12 weeks, and exceptional cost-effectiveness with a public value return on investment ratio of GBP 30.49 per GBP 1 invested and a cost per QALY of GBP 487. There have been many challenges in implementing this service, underpinned by the system-wide culture change and ensuring the good communication and engagement of all stakeholders across the complex networks of the tobacco control and healthcare system. The delivery of hospital-based tobacco dependency services across all NHS acute care hospitals represents a substantial step forward in the fight against the tobacco epidemic. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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16 pages, 544 KiB  
Article
Operationalizing Leadership and Clinician Buy-In to Implement Evidence-Based Tobacco Treatment Programs in Routine Oncology Care: A Mixed-Method Study of the U.S. Cancer Center Cessation Initiative
by Sarah D. Hohl, Jennifer E. Bird, Claire V. T. Nguyen, Heather D’Angelo, Mara Minion, Danielle Pauk, Robert T. Adsit, Michael Fiore, Margaret B. Nolan and Betsy Rolland
Curr. Oncol. 2022, 29(4), 2406-2421; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29040195 - 29 Mar 2022
Cited by 4 | Viewed by 1998
Abstract
Background: Delivering evidence-based tobacco dependence treatment in oncology settings improves smoking abstinence and cancer outcomes. Leadership engagement/buy-in is critical for implementation success, but few studies have defined buy-in or described how to secure buy-in for tobacco treatment programs (TTPs) in cancer care. This [...] Read more.
Background: Delivering evidence-based tobacco dependence treatment in oncology settings improves smoking abstinence and cancer outcomes. Leadership engagement/buy-in is critical for implementation success, but few studies have defined buy-in or described how to secure buy-in for tobacco treatment programs (TTPs) in cancer care. This study examines buy-in during the establishment of tobacco treatment programs at National Cancer Institute (NCI)-designated cancer centers. Methods: We utilized a sequential, explanatory mixed-methods approach to analyze quantitative data and qualitative interviews with program leads in the U.S.-based NCI Moonshot-supported Cancer Center Cessation Initiative (n = 20 Centers). We calculated descriptive statistics and applied structural coding and content analysis to qualitative data. Results: At least 75% of participating centers secured health care system administrative, clinical, and IT leadership buy-in and support. Six themes emerged from interviews: engaging leadership, access to resources, leveraging federal funding support to build leadership interest, designating champions, identifying training needs, and ensuring staff roles and IT systems support workflows. Conclusions: Buy-in among staff and clinicians is defined by the belief that the TTP is necessary, valuable, and evidence based. Recognizing and securing these dimensions of buy-in can facilitate implementation success, leading to improved cancer outcomes. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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9 pages, 220 KiB  
Article
Challenges and Adaptations for Providing Smoking Cessation for Patients with Cancer across Canada during the COVID-19 Pandemic
by Graham W. Warren, Caroline Silverman and Michelle Halligan
Curr. Oncol. 2022, 29(4), 2263-2271; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29040184 - 24 Mar 2022
Cited by 2 | Viewed by 1884
Abstract
Smoking cessation after a cancer diagnosis can improve health outcomes, but the Coronavirus disease 2019 (COVID-19) pandemic significantly altered healthcare patterns and strained resources, including for smoking cessation support for cancer patients. A Network that included all 13 provinces and territories (jurisdictions) in [...] Read more.
Smoking cessation after a cancer diagnosis can improve health outcomes, but the Coronavirus disease 2019 (COVID-19) pandemic significantly altered healthcare patterns and strained resources, including for smoking cessation support for cancer patients. A Network that included all 13 provinces and territories (jurisdictions) in Canada received funding and coordinated support from a national organization to implement access to smoking cessation support in cancer care between 2016 and 2021, including throughout the COVID-19 pandemic. Descriptive analyses of meetings between the organization and jurisdictions between March of 2020 and August of 2021 demonstrated that all jurisdictions reported disruptions of existing smoking cessation approaches. Common challenges include staff redeployment, inability to deliver support in person, disruptions in travel, and loss of connections with other clinical resources. Common adaptations included budget and workflow adjustments, transition to virtual approaches, partnering with other community resources, and coupling awareness of the harms of smoking and COVID-19. All jurisdictions reported adaptations that maintained or improved access to smoking cessation services. Collectively, data suggest coordinated national efforts to address smoking cessation in cancer care could be crucial to maintaining access during an international healthcare crisis. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
14 pages, 526 KiB  
Article
Engaging Patients in Smoking Cessation Treatment within the Lung Cancer Screening Setting: Lessons Learned from an NCI SCALE Trial
by Randi M. Williams, Ellie Eyestone, Laney Smith, Joanna G. Philips, Julia Whealan, Marguerite Webster, Tengfei Li, George Luta, Kathryn L. Taylor and on behalf of the Lung Screening, Tobacco, Health Trial
Curr. Oncol. 2022, 29(4), 2211-2224; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29040180 - 23 Mar 2022
Cited by 3 | Viewed by 2515
Abstract
Offering smoking cessation treatment at lung cancer screening (LCS) will maximize mortality reduction associated with screening, but predictors of treatment engagement are not well understood. We examined participant characteristics of engagement in an NCI SCALE cessation trial. Eligible LCS patients (N = 818) [...] Read more.
Offering smoking cessation treatment at lung cancer screening (LCS) will maximize mortality reduction associated with screening, but predictors of treatment engagement are not well understood. We examined participant characteristics of engagement in an NCI SCALE cessation trial. Eligible LCS patients (N = 818) were randomized to the Intensive arm (8 phone counseling sessions +8 weeks of nicotine replacement therapy (NRT)) vs. Minimal arm (3 sessions + 2 weeks of NRT). Engagement was measured by number of sessions completed (none, some, or all) and NRT mailed (none vs. any) in each arm. In the Intensive arm, those with ≥some college (OR = 2.1, 95% CI = 1.1, 4.0) and undergoing an annual scan (OR = 2.1, 95% CI = 1.1, 4.2) engaged in some counseling vs. none. Individuals with higher nicotine dependence were more likely (OR = 2.8, 95% CI = 1.3, 6.2) to request NRT. In the Minimal arm, those with higher education (OR = 2.1, 95% CI = 1.1, 3.9) and undergoing an annual scan (OR = 2.0, 95% CI = 1.04, 3.8) completed some sessions vs. none. Requesting NRT was associated with more pack-years (OR = 1.9, 95% CI = 1.1, 3.5). Regardless of treatment intensity, additional strategies are needed to engage those with lower education, less intensive smoking histories, and undergoing a first scan. These efforts will be important given the broader 2021 LCS guidelines. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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Review

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14 pages, 288 KiB  
Review
Smoking Cessation after Cancer Diagnosis and Enhanced Therapy Response: Mechanisms and Significance
by Srikumar Chellappan
Curr. Oncol. 2022, 29(12), 9956-9969; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29120782 - 17 Dec 2022
Cited by 6 | Viewed by 2814
Abstract
The adverse effects of smoking on human health have been recognized for several decades, especially in the context of cancer. The ability of tobacco smoke components, including tobacco-specific carcinogens and additive compounds such as nicotine, to initiate or promote tumor growth have been [...] Read more.
The adverse effects of smoking on human health have been recognized for several decades, especially in the context of cancer. The ability of tobacco smoke components, including tobacco-specific carcinogens and additive compounds such as nicotine, to initiate or promote tumor growth have been described in hundreds of studies. These investigations have revealed the tumor-promoting activities of nicotine and other tobacco smoke components and have also recognized the ability of these agents to suppress the efficacy of cancer therapy; it is now clear that smoking can reduce the efficacy of most of the widely used therapeutic modalities, including immunotherapy, radiation therapy, and chemotherapy. Several studies examined if continued smoking after cancer diagnosis affected therapy response; it was found that while never smokers or non-smokers had the best response to therapy, those who quit smoking at the time of diagnosis had higher overall survival and reduced side-effects than those who continued to smoke. These studies also revealed the multiple mechanisms via which smoking enhances the growth and survival of tumors while suppressing therapy-induced cell death. In conclusion, smoking cessation during the course of cancer therapy markedly increases the chances of survival and the quality of life. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
8 pages, 249 KiB  
Review
Advancing Tobacco Cessation in LMICs
by Abhishek Shankar, Mark Parascandola, Pirabu Sakthivel, Jagdish Kaur, Deepak Saini and Naveen Prabhu Jayaraj
Curr. Oncol. 2022, 29(12), 9117-9124; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29120713 - 23 Nov 2022
Cited by 3 | Viewed by 1805
Abstract
Tobacco kills more than 8 million people worldwide every year. Over 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries (LMICs), where the future burden is projected to grow. At the same time, progress in tobacco control has [...] Read more.
Tobacco kills more than 8 million people worldwide every year. Over 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries (LMICs), where the future burden is projected to grow. At the same time, progress in tobacco control has not advanced as far as in many LMICs. In particular, the implementation of tobacco-cessation programs and interventions remains limited. The bulk of the evidence for tobacco-cessation interventions comes from high-income countries and may not reflect the context in LMICs, particularly as resources and training for tobacco cessation are limited. This paper summarizes the current evidence for tobacco-cessation interventions in LMICs and highlights some key challenges and research gaps. Overall, there is a need to build capacity for locally relevant research and implementation science to support tailored cessation interventions and strategies for LMICs. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
9 pages, 252 KiB  
Review
The Tobacco Endgame—A New Paradigm for Smoking Cessation in Cancer Clinics
by Emily Stone and Christine Paul
Curr. Oncol. 2022, 29(9), 6325-6333; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29090497 - 01 Sep 2022
Cited by 1 | Viewed by 2322
Abstract
Smoking cessation represents an untapped resource for cancer therapy. Many people who smoke and have cancer (tobacco-related or otherwise) struggle to quit and as a result, jeopardise response to treatment, recovery after surgery and long-term survival. Many health care practitioners working in cancer [...] Read more.
Smoking cessation represents an untapped resource for cancer therapy. Many people who smoke and have cancer (tobacco-related or otherwise) struggle to quit and as a result, jeopardise response to treatment, recovery after surgery and long-term survival. Many health care practitioners working in cancer medicine feel undertrained, unprepared and unsupported to provide effective smoking cessation therapy. Many institutions and healthcare systems do provide smoking cessation programs, guidelines and referral pathways for cancer patients, but these may be unevenly applied. The growing body of evidence, from both retrospective and prospective clinical studies, confirms the benefit of smoking cessation and will provide much needed evidence for the best and most effective interventions in cancer clinics. In addition to reducing demand, helping cancer patients quit and treating addiction, a firm commitment to developing smoke free societies may transform cancer medicine in the future. While the Framework Convention for Tobacco Control (FCTC) has dominated global tobacco control for the last two decades, many jurisdictions are starting to develop plans to make their communities tobacco free, to introduce the tobacco endgame. Characterised by downward pressure on tobacco supply, limited sales, limited access and denormalization of smoking, these policies may radically change the milieu in which people with cancer receive treatment, in which health care practitioners refine skills and which may ultimately foster dramatic improvements in cancer outcomes. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
17 pages, 1284 KiB  
Review
Tobacco Use and Response to Immune Checkpoint Inhibitor Therapy in Non-Small Cell Lung Cancer
by Lucy K. Corke, Janice J. N. Li, Natasha B. Leighl and Lawson Eng
Curr. Oncol. 2022, 29(9), 6260-6276; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29090492 - 30 Aug 2022
Cited by 7 | Viewed by 3525
Abstract
Tobacco is a known risk factor for lung cancer, and continued tobacco use is associated with poorer outcomes across multiple lung cancer treatment modalities including surgery, chemotherapy and radiation therapy. Less is known about the association of tobacco use and outcomes with immune [...] Read more.
Tobacco is a known risk factor for lung cancer, and continued tobacco use is associated with poorer outcomes across multiple lung cancer treatment modalities including surgery, chemotherapy and radiation therapy. Less is known about the association of tobacco use and outcomes with immune checkpoint inhibitors (ICIs), which are becoming an important part of the treatment landscape in lung cancer, both in metastatic and curative settings. We reviewed the literature on the association of tobacco and tumor biology as it relates to immunotherapy. We also reviewed the association of tobacco use on outcomes among phase III randomized clinical trials involving ICIs in non-small cell lung cancer (NSCLC). We identified that patients with a smoking history may have a greater benefit with ICI treatment compared to never smokers in both treatment-naïve (HR 0.82, 95% CI 0.69–0.97, vs. HR 1.06, 95% CI 0.81–1.38) and pre-treated (HR 0.79, 95% CI 0.70–0.90 vs. 1.03, 95% CI 0.74–1.43) settings. In trials where smoking status was further defined, ex-smokers appear to demonstrate greater benefit with ICI therapy compared to current smokers (HR 0.78, 95% CI 0.59–1.01 vs. 0.91, 95% CI 0.72–1.14). We conclude by offering our perspective on future directions in this area of research, including implementation of standardized collection and analysis of tobacco use in clinical trials involving ICI therapy in lung cancer and other disease sites, and also evaluating how tobacco may affect toxicities related to ICI therapy. Based on our review, we believe that a patient’s history of tobacco smoking does have a role to play in guiding treatment decision making in patients with lung cancer. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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17 pages, 306 KiB  
Review
Impact of Tobacco Smoking on Outcomes of Radiotherapy: A Narrative Review
by Adrian Perdyan and Jacek Jassem
Curr. Oncol. 2022, 29(4), 2284-2300; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29040186 - 24 Mar 2022
Cited by 6 | Viewed by 2623
Abstract
The carcinogenic role of tobacco smoking is well recognized, but the detrimental effects of continued smoking after a cancer diagnosis have been underestimated. Radiotherapy is among the main treatment modalities for cancer. We reviewed the literature data concerning the impact of tobacco smoking [...] Read more.
The carcinogenic role of tobacco smoking is well recognized, but the detrimental effects of continued smoking after a cancer diagnosis have been underestimated. Radiotherapy is among the main treatment modalities for cancer. We reviewed the literature data concerning the impact of tobacco smoking on treatment outcomes in radiotherapy-managed patients with various malignancies. Most of the analyzed studies demonstrated the detrimental effect of smoking on overall survival, tumor control, quality of life, treatment toxicity, and the incidence of second primary malignancies. Healthcare professionals should use the cancer diagnosis and treatment as a teachable moment and recommend their patients to immediately cease smoking. Wherever possible, cancer patients should undergo an intensive smoking-cessation program, including behavioral and pharmacologic therapy. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)

Other

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6 pages, 197 KiB  
Commentary
Confronting the Negative Impact of Cigarette Smoking on Cancer Surgery
by Se-In Choe and Christian Finley
Curr. Oncol. 2022, 29(8), 5869-5874; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29080463 - 18 Aug 2022
Cited by 1 | Viewed by 1447
Abstract
Smoking is a common health risk behavior that has substantial effects on perioperative risk and postoperative surgical outcomes. Current smoking is clearly linked to an increased risk of perioperative cardiovascular, pulmonary and wound healing complications. Accumulating evidence indicates that smoking cessation can reduce [...] Read more.
Smoking is a common health risk behavior that has substantial effects on perioperative risk and postoperative surgical outcomes. Current smoking is clearly linked to an increased risk of perioperative cardiovascular, pulmonary and wound healing complications. Accumulating evidence indicates that smoking cessation can reduce the higher perioperative complication risk that is observed in current smokers. In addition, continued smoking has a negative impact on the overall prognosis of cancer patients. Smoking cessation, on the other hand, can improve long-term outcomes after surgery. Smoking cessation services should be implemented in a comprehensive programmatic manner to ensure that all patients gain access to evidence-based care. Although the benefits of abstinence increase in proportion to the length of cessation, cessation should be recommended regardless of timing prior to surgery. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
8 pages, 795 KiB  
Commentary
Evolution of a Systematic Approach to Smoking Cessation in Ontario’s Regional Cancer Centres
by Erin Cameron, Vicki Lee, Sargam Rana, Mohammad Haque, Naomi Schwartz, Sahara Khan, Rebecca Truscott and Linda Rabeneck
Curr. Oncol. 2022, 29(7), 4604-4611; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29070365 - 30 Jun 2022
Cited by 1 | Viewed by 1522
Abstract
Smoking cessation after a cancer diagnosis can significantly improve a person’s prognosis, treatment efficacy and safety, and quality of life. In 2012, Cancer Care Ontario (now part of Ontario Health) introduced a Framework for Smoking Cessation, to be implemented for new ambulatory cancer [...] Read more.
Smoking cessation after a cancer diagnosis can significantly improve a person’s prognosis, treatment efficacy and safety, and quality of life. In 2012, Cancer Care Ontario (now part of Ontario Health) introduced a Framework for Smoking Cessation, to be implemented for new ambulatory cancer patients at the province’s 14 Regional Cancer Centres (RCCs). Over time, the program has evolved to become more efficient, use data for robust performance management, and broaden its focus to include new patient populations and additional data collection. In 2017, the framework was revised from a 5As to a 3As brief intervention model, along with an opt-out approach to referrals. The revised model was based on emerging evidence, feedback from stakeholders, and an interim program evaluation. Results showed an initial increase in referrals to cessation services. Two indicators (tobacco use screening and acceptance of a referral) are routinely monitored as part of Ontario Health’s system-wide performance management approach, which has been identified as a key driver of change among RCCs. Due to the COVID-19 pandemic, many RCCs reported a decrease in these indicators. RCCs that were able to maintain a high level of smoking cessation activities during the pandemic offer valuable lessons, including the opportunity to swiftly leverage virtual care. Future directions for the program include capturing data on cessation outcomes and expanding the intervention to new populations. A focus on system recovery from COVID-19 will be paramount. Smoking cessation must remain a core element of high-quality cancer care, so that patients achieve the best possible health benefits from their treatments. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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11 pages, 253 KiB  
Commentary
Smoking Cessation Training and Treatment: Options for Cancer Centres
by Wayne K. deRuiter, Megan Barker, Alma Rahimi, Anna Ivanova, Laurie Zawertailo, Osnat C. Melamed and Peter Selby
Curr. Oncol. 2022, 29(4), 2252-2262; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29040183 - 24 Mar 2022
Cited by 3 | Viewed by 2636
Abstract
Patients who achieve smoking cessation following a cancer diagnosis can experience an improvement in treatment response and lower morbidity and mortality compared to individuals who continue to smoke. It is therefore imperative for publicly funded cancer centres to provide appropriate training and education [...] Read more.
Patients who achieve smoking cessation following a cancer diagnosis can experience an improvement in treatment response and lower morbidity and mortality compared to individuals who continue to smoke. It is therefore imperative for publicly funded cancer centres to provide appropriate training and education for healthcare providers (HCP) and treatment options to support smoking cessation for their patients. However, system-, practitioner-, and patient-level barriers exist that hamper the integration of evidence-based cessation programs within publicly funded cancer centres. The integration of evidence-based smoking cessation counselling and pharmacotherapy into cancer care facilities could have a significant effect on smoking cessation and cancer treatment outcomes. The purpose of this paper is to describe the elements of a learning health system for smoking cessation, implemented and scaled up in community settings that can be adapted for ambulatory cancer clinics. The core elements include appropriate workflows enabled by technology, thereby improving both practitioner and patient experience and effectively removing practitioner-level barriers to program implementation. Integrating the smoking cessation elements of this program from primary care to cancer centres could improve smoking cessation outcomes in patients attending cancer clinics. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
10 pages, 1008 KiB  
Perspective
Perspective on Cancer Control: Whither the Tobacco Endgame for Canada?
by Elizabeth A. Eisenhauer, Robert Schwartz, Rob Cunningham, Les Hagen, Geoffrey T. Fong, Cynthia Callard, Michael Chaiton and Andrew Pipe
Curr. Oncol. 2022, 29(3), 2081-2090; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29030168 - 18 Mar 2022
Cited by 1 | Viewed by 2430
Abstract
Aims: In 2014, in response to evidence that Canada’s tobacco use would lead, inexorably, to substantial morbidity and mortality for the foreseeable future, a group of experts convened to consider the development of a “Tobacco Endgame” for Canada. The “Tobacco Endgame” defines a [...] Read more.
Aims: In 2014, in response to evidence that Canada’s tobacco use would lead, inexorably, to substantial morbidity and mortality for the foreseeable future, a group of experts convened to consider the development of a “Tobacco Endgame” for Canada. The “Tobacco Endgame” defines a time frame in which to eliminate structural, political, and social dynamics that sustain tobacco use, leading to improved population health. Strategies: A series of Background Papers describing possible measures that could contribute to the creation of a comprehensive endgame strategy for Canada was prepared in advance of the National Tobacco Endgame Summit hosted at Queen’s University in 2016. At the summit, agreement was reached to work together to achieve <5% tobacco use by 2035 (<5 by ’35). A report of the proceedings was shared widely. Achievements: Progress since 2016 has been mixed. The Summit report was followed by a national forum convened by Health Canada in March 2017, and in 2018, the Canadian Government adopted “<5 × ’35” tobacco use target in a renewed Canadian tobacco reduction strategy. Tobacco use has declined in the last 5 years, but at a rate slower than that which will be needed to achieve the <5 by ’35 goal. There remain > 5 million smokers in Canada, signaling that smoking-related diseases will continue to be an enormous health burden. Furthermore, the landscape of new products (e-cigarettes and cannabis) has created additional risks and opportunities. Future directions: A bold, reinvigorated tobacco control strategy is needed that significantly advances ongoing policy developments, including full implementation of the key demand-reduction policies of the WHO Framework Convention on Tobacco Control. Formidable, new disruptive policies and regulations will be needed to achieve Canada’s Endgame goal. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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6 pages, 203 KiB  
Commentary
Pivoting the Provision of Smoking Cessation Education in a Virtual Clinical World: The Princess Margaret Cancer Centre Experience
by Naa Kwarley Quartey, Janet Papadakos, Ben Umakanthan and Meredith Elana Giuliani
Curr. Oncol. 2021, 28(6), 5395-5400; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol28060449 - 15 Dec 2021
Cited by 3 | Viewed by 2362
Abstract
Continued smoking after a cancer diagnosis may be attributed to misbeliefs by both patients and healthcare providers on the value and benefit of quitting smoking on treatment outcomes. The perceived myths and misconceptions about the relationship between smoking and cancer may be readily [...] Read more.
Continued smoking after a cancer diagnosis may be attributed to misbeliefs by both patients and healthcare providers on the value and benefit of quitting smoking on treatment outcomes. The perceived myths and misconceptions about the relationship between smoking and cancer may be readily dispelled with the provision of practical and pertinent education. However, busy clinics as well as the rapid move to virtual care due to the COVID-19 pandemic present several challenges with the provision of smoking cessation education. Here, we describe how the Princess Margaret Cancer Centre implemented innovative solutions to improve the delivery of education during the COVID-19 pandemic to better support patients and healthcare providers. Full article
(This article belongs to the Special Issue Smoking Cessation after a Cancer Diagnosis)
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