Predictors of enrollment and cessation outcomes in a telehealth opt-out tobacco treatment program

This study explores predictors of reach, enrollment, and smoking outcomes among patients referred to a telehealth-pharmacy assisted tobacco treatment program (TTP). Between May 2021 and December 2022, 35756 adult patients from 43 oncology clinics were screened for cigarette use, and 3319 current smokers were referred to the TTP. Reach was defined as the proportion of cigarette smokers referred to the TTP who were contacted by phone. Program enrollment was defined as the proportion of patients reached by phone who enrolled in the TTP, and overall enrollment was defined as the proportion of all identified cigarette smokers who were referred to and enrolled in the TTP. A subsample of 420 enrolled patients was selected for follow-up interviews, with 167 completing assessments of smoking status 4–12 months after enrollment. Older patients with cancer were more likely to be reached by phone. Those with cancer and non-White patients were more likely to enroll in the TTP once contacted. About 1/3 of patients reached at follow-up reported not smoking. Forty-five percent of patients who smoked and were referred to the TTP enrolled and 1/3 of patients who were contacted 4–12 months after enrolling in the TTP reported no longer smoking. What this paper adds This paper explores predictors of reach, enrollment, and smoking outcomes among 3319 patients referred to a telehealth-pharmacy assisted opt-out tobacco treatment program (TTP) for patients seen in oncology outpatient clinics. Among current cigarette smokers referred to the TTP, 72% were reached by phone, of those reached by phone, 63% enrolled in the TTP (i.e. program enrollment). Among all identified current smokers referred to the TTP, 45% enrolled in the TTP (i.e. overall enrollment). Overall enrollment rates were higher in patients who were older, non-White, and had a diagnosis of cancer, suggesting the opt-out approach helped to deliver smoking cessation treatments to patient groups, who based on prior studies, often do not receive treatment support to quit smoking. Among patients enrolled in the TTP, about 1/3 reported not smoking at follow-up 4–12 months after enrollment; 24% of those still smoking said they still wanted assistance to help them stop smoking.