Design, implementation, and evaluation of an intervention to improve referral to smoking cessation services in breast cancer patients

Nolan, Margaret; Ridgeway, Jennifer L.; Ghosh, Karthik; Martin, David P.; Warner, David O.

doi:10.1007/s00520-018-4486-5

Cited by 13 publications

(34 citation statements)

References 18 publications

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“…It shows promising results in terms of increasing patient attendance to tobacco treatment and subsequent quit rates compared with the traditional opt-in approach, although further work is necessary to evaluate long-term cessation efficacy. [21][22][23][24][25][35][36][37] Although increasing quit rates among patients with cancer is clearly beneficial, the possibility of interfering with patient autonomy is real.…”

Section: Does the Opt-out Approach To Tobacco Treatment Referral Violate Patient Autonomy?mentioning

confidence: 99%

“…20 Several participating cancer centers have begun using an optout approach to refer all patients to tobacco treatment, with encouraging results in terms of increasing the reach and effectiveness of tobacco treatment for patients with cancer. [21][22][23][24][25] Although the potential benefits of referral are clear, there are also important questions about the ethical justifiability of such practices, such as whether doing so violates patient autonomy or results in unintended consequences. Although the seminal paper proposing the opt-out approach discussed some of these issues, and generated lively correspondence, no study has yet explored in detail the ethical considerations in implementing this approach.…”

mentioning

confidence: 99%

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Presumed Consent With Opt-Out: An Ethical Consent Approach to Automatically Refer Patients With Cancer to Tobacco Treatment Services

Ohde

Master

Tilburt

et al. 2021

JCO

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Section: Does the Opt-out Approach To Tobacco Treatment Referral Violate Patient Autonomy?mentioning

confidence: 99%

mentioning

confidence: 99%

Presumed Consent With Opt-Out: An Ethical Consent Approach to Automatically Refer Patients With Cancer to Tobacco Treatment Services

Ohde

Master

Tilburt

et al. 2021

JCO

Self Cite

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“…The opt-out model has increased patient reach and engagement [13], and quit rates [14]. "Opt-out" models for tobacco treatment have proven feasible in inpatient and cancer care settings [15,16].…”

Section: Introductionmentioning

confidence: 99%

Integration of Tobacco Treatment Services into Cancer Care at Stanford

Gali

Pike

Kendra

et al. 2020

IJERPH

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As part of a National Cancer Institute Moonshot P30 Supplement, the Stanford Cancer Center piloted and integrated tobacco treatment into cancer care. This quality improvement (QI) project reports on the process from initial pilot to adoption within 14 clinics. The Head and Neck Oncology Clinic was engaged first in January 2019 as a pilot site given staff receptivity, elevated smoking prevalence, and a high tobacco screening rate (95%) yet low levels of tobacco cessation treatment referrals (<10%) and patient engagement (<1% of smokers treated). To improve referrals and engagement, system changes included an automated “opt-out” referral process and provision of tobacco cessation treatment as a covered benefit with flexible delivery options that included phone and telemedicine. Screening rates increased to 99%, referrals to 100%, 74% of patients were reached by counselors, and 33% of those reached engaged in treatment. Patient-reported abstinence from all tobacco products at 6-month follow-up is 20%. In July 2019, two additional oncology clinics were added. In December 2019, less than one year from initiating the QI pilot, with demonstrated feasibility, acceptability, and efficacy, the tobacco treatment services were integrated into 14 clinics at Stanford Cancer Center.

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“…Our results indicate that there is room for improvement, as referral to a specialist is a useful action. Nolan et al implemented an intervention in which all breast cancer patients who smoked were referred to smoking cessation services [ 39 ]. The proportion of smoking patients referred to a specialist in smoking cessation increased from 29% (22/75) before the intervention to 74% (20/27) afterward.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer (BC) Is a Window of Opportunity for Smoking Cessation: Results of a Retrospective Analysis of 1234 BC Survivors in Follow-Up Consultation

Nicolas

Grandal

Dubost

et al. 2021

Cancers

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Breast cancer (BC) is the most commonly diagnosed type of cancer and the leading cause of cancer deaths in women. Smoking is the principal modifiable risk factor for cancers and has a negative influence on long-term survival. We conducted a retrospective study on consecutive BC survivors seen at follow-up consultations between 3 June and 30 October 2019 at Institut Curie, Paris, France. Smoking behaviors were evaluated prospectively via interviewer-administered questionnaires. The aim of this study was to describe smoking-related patient care at diagnosis and smoking cessation patterns in women with a history of BC. A total of 1234 patients were included in the study. Smoking status at diagnosis was missing from electronic health records in 32% of cases, including 13% of patients who smoke. Only 20% of the 197 patients currently smoking at diagnosis recalled having a discussion about smoking with a healthcare professional. Radiotherapists and surgeons were more likely to talk about complications than other practitioners. The main type of information provided was general advice to stop smoking (n = 110), followed by treatment complications (n = 48), while only five patients were referred to tobaccologists. Since diagnosis, 33% (n = 65) of the patients currently smoking had quit. Patients who quit had a lower alcohol consumption, but no other factor was associated with smoking cessation. The main motivation for tobacco withdrawal was the fear of BC relapse (63%). This study highlights room for improvement in the assessment of smoking behavior. Our data raise important perspectives for considering BC treatment and follow-up as a window of opportunity for smoking cessation.

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Design, implementation, and evaluation of an intervention to improve referral to smoking cessation services in breast cancer patients

Cited by 13 publications

References 18 publications

Presumed Consent With Opt-Out: An Ethical Consent Approach to Automatically Refer Patients With Cancer to Tobacco Treatment Services

Presumed Consent With Opt-Out: An Ethical Consent Approach to Automatically Refer Patients With Cancer to Tobacco Treatment Services

Integration of Tobacco Treatment Services into Cancer Care at Stanford

Breast Cancer (BC) Is a Window of Opportunity for Smoking Cessation: Results of a Retrospective Analysis of 1234 BC Survivors in Follow-Up Consultation

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