Abstract
Context: Cancer patients' continued tobacco use results in poorer therapeutic outcomes including decreased quality of life and survival. Objective: To assess reach and impact of a free, opt-out, telephone-based tobacco cessation program for thoracic cancer center patients. Design: Observational study. Setting: Comprehensive Cancer Center in Western New York. Participants: Current or recent (within past 30 days) tobacco-using thoracic cancer center patients referred to a tobacco cessation support service between October 2010 and October 2012 at a Comprehensive Cancer Center (n = 942/1313 referrals were eligible for cessation support). Intervention: A free, opt-out, telephone-based cessation service that was implemented as standard of care. Cessation specialists had patient-guided conversations that assessed readiness to quit; methods used in the past provided cessation strategies and worked to set up a quit date. There was an average of 35.9 days between referral and first contact. Main Outcome Measures: Program reach (referral and participation rates) and impact (as self-reported cessation outcomes measured twice after referral). Results: Of 942 patients, 730 (77.5%) referred to and called by a tobacco cessation service participated in at least 1 cessation support call, of which 440 of 730 (60.3%) were called for follow-up and 89.5% (394/440) participated. In total, 20.2% (69/342) of current smokers at referral reported at least 7-day abstinence at follow-up. Among current smokers at referral and first contact, being married (odds ratio [OR] = 2.05; 95% confidence interval [CI], 1.01-4.18) and having a lower Eastern Cooperative Oncology Group (ECOG) performance score (OR = 4.05; 95% CI, 1.58-10.39) were associated with quitting at follow-up, after controlling for demographic, clinical, and health behavior characteristics. Conclusions: Our results demonstrate that 78% of thoracic cancer center patients, if contacted, participated at least once in this cessation support service; for current smokers at referral and first contact, being married and having a lower ECOG performance score were associated with self-reported quitting at follow-up. Other organizations may find our results useful while implementing a systematic way to identify tobacco-using patients as part of routine care and to improve available cessation support services.
| Original language | English |
|---|---|
| Pages (from-to) | E12-E19 |
| Journal | Journal of Public Health Management and Practice |
| Volume | 24 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2018 |
Bibliographical note
Publisher Copyright:© 2018 Wolters Kluwer Health, Inc. All rights reserved.
Funding
Community Health and Health Behavior (Dr Giovino), University at Buffalo, pulmonary disease and is a major cardiovascular Buffalo, New York; and Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina (Dr Warren). This work was supported in part by the Roswell Park Alliance Foundation and NCI R25CA113951. The authors acknowledge and thank Patricia Hysert, Robert Hysert, and Stephanie Segal for their commitment to providing cessation support, and Robert Reed, MPH, K. Michael Cummings, PhD, Michael Zevon, PhD, and James Marshall, PhD, for their contributions to and support of the cessation service. The authors also thank Linda Kahn, PhD, at the University at Buffalo Primary Care Research Institute for support during the submission of this article.
| Funders | Funder number |
|---|---|
| National Childhood Cancer Registry – National Cancer Institute | R25CA113951 |
| Roswell Park Cancer Institute Alliance Foundation |
Keywords
- cessation program
- lung cancer
- smoking cessation
- tobacco
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health
