Telehealth Delivery of Tobacco Cessation Treatment in Cancer Care: An Ongoing Innovation Accelerated by the COVID-19 Pandemic

Abstract

The COVID-19 pandemic precipitated a rapid transformation in healthcare delivery. Ambulatory care abruptly shifted from in-person to telehealth visits with providers using digital video and audio tools to reach patients at home. Advantages to telehealth care include enhanced patient convenience and provider efficiencies, but financial, geographic, privacy, and access barriers to telehealth also exist. These are disproportionately greater for older adults and for those in rural areas, low-income communities, and communities of color, threatening to worsen preexisting disparities in tobacco use and health. Pandemic-associated regulatory changes regarding privacy and billing allowed many Cancer Center Cessation Initiative (C3I) programs in NCI-designated Cancer Centers to start or expand video-based telehealth care. Using 3 C3I programs as examples, we describe the methods used to shift to telehealth delivery. Although telephone-delivered treatment was already a core tobacco treatment modality with a robust evidence base, little research has yet compared the effectiveness of tobacco cessation treatment delivery by video versus phone or in-person modalities. Video-delivery has shown greater medication adherence, higher patient satisfaction, and better retention in care than phone-based delivery, and may improve cessation outcomes. We outline key questions for further investigation to advance telehealth for tobacco cessation treatment in cancer care.

Study protocol for a hybrid type 1 effectiveness-implementation trial testing virtual tobacco treatment in oncology practices [Smokefree Support Study 2.0]

“…To the best of our knowledge, this is the first study to deliver tobacco treatment virtually to recently diagnosed patients treated nationally at community cancer centers. There has been much recent enthusiasm [73] for the use of remote videoconference for tobacco treatment. Videoconferencing improves access to treatment by bringing tobacco counselor expertise directly to patients (synchronous visits) and into community cancer centers.…”

Integrating Tobacco Use Assessment and Treatment in the Oncology Setting: Quality Improvement Results from the Georgetown Lombardi Smoking Treatment and Recovery Program

“…Furthermore, offering multiple treatment modalities may appeal to patients’ personal preferences while also having similar abstinence rates [ 21 , 22 ]. Although telehealth visits have been shown to have lower no-show rates [ 23 ] and similar patient satisfaction levels [ 24 ] compared to in-person visits, disparities in digital access continue to exist [ 25 , 26 ], highlighting the need to offer both (non-video) phone and in-person counseling [ 27 ].…”