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Let's Discuss: Tobacco Control and Cancer Survivorship: From Science to Strategies

I was so delighted not only to convene today's cyber-seminar but on behalf of the Comprehensive Cancer Control National Partnership kickoff the first of a three-part series to highlight innovative and successful interventions designed to deliver evidence-based tobacco control interventions to patients and survivors.
 
The negative impact of tobacco use on the short and long-term prognosis of cancer patients and survivors is well documented and becoming increasingly understood within and beyond the cancer community. However, uptake and implementation of practices and resources targeted at promoting tobacco cessation amongst cancer patients and survivors remains slow. 
 
We would appreciate hearing from you: what do you find "works best" in reaching this important group with tobacco cessation strategies? 

Posts/Comments

We had a few questions that

We had a few questions that came in that we could not get to within the hour - Sarah, Jane and Elyse will weigh in on these shortly

  • How did you track patient quit effectiveness from the referral at the clinic, to the quitline, and then back to the clinic? Did you use a certain data management system? How did you gain access to it?
  • Even with the program marketing and staff education, did you continue to find it challenging to have patients take advantage of the Quit Line or enroll in the classes? And if so, what strategies did you employ to overcome that?
  • Who did you partner with first?

What other questions do you have of our speakers?

As mentioned, Dr. Park sent

As mentioned, Dr. Park sent over her latest publication as of 6/16/15 and shared the link with us! You can read Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation Among Participants in the National Lung Screening Trial and check out our other great related content and resources on the cyber-seminar page

MOQC Tracking of Referral and

  1. MOQC Tracking of Referral and Quit Effectiveness: In collaboration with our State Tobacco Section and the Quitline, MOQC-participating sites are tagged as MOQC in the Quitline data base.  The Quitline sends a patient -specific status report back to each clinic including the following: Referral received; Pt contact initiated or failed, Intake, Counseling completed, NRT's sent etc.MOQC also receives periodic summary reports by practice location ( no patient level data) with enrollment status data. Quit data was obtained by the Quitline.
  2. Challenges to enrolling in Quitline: Yes, It continues to be very challenging to engage pts in the Quitline or local counseling services.  Strategies we have used include: free NRT when they enroll (may not free however for a spouse if they want to do Quitline too which is a problem); MI training for practice staff, standard messaging, placing the referal on behalf of the pt, telling pt to expect call from quitline and what number to expect, programming  Quitline number into the phone, ASK/ ADVISE as 6 th vital sign on every visit. We have great opportunity to improve and would love to hear strategies that have worked for others.

In response to the question

In response to the question of who we partnered with first, the Michigan Cancer Consortium, which is supported by Michigan Department of Health and Human Services (MDHHS) cancer control staff, had a relationship with the Michigan Oncology Quality Consortium (MOQC).  MDHHS cancer control staff also work closely with the MDHHS tobacco program.  So, the cancer control staff worked first within their partnership with MOQC and then with the state tobacco program (and the Quitline provided through National Jewish Health) and the collaborative was formed.

On Monday, July 20th, the

On Monday, July 20th, the George Washington University Cancer Institute presented Tobacco Cessation Resources for Cancer Patients and Survivors: Current Landscape and Call to Action.  This webinar is second in a three-part series hosted with Comprehensive Cancer Control National Partnership organizations, discussing tobacco cessation services for cancer survivors from the perspectives of research, practice, and coalition examples.

Dr. Jamie Ostroff, Director of Memorial Sloan Kettering Cancer Center's Tobacco Treatment Program, discussed the practice-related aspects of this issue including:

  • Best practices in promoting tobacco cessation among cancer patients and survivors.
  • Current gaps in promoting tobacco cessation among cancer patients and survivors.
  • Integration of tobacco cessation services across models of oncology care.
  • Resources available for achieving tobacco cessation among cancer patients and survivors.
  • Opportunities and strategies to increase implementation of tobacco cessation best practices and address gaps.

A link to this excellent and engaing presentation is below:

 

As promised, I am attaching

As promised, I am attaching the JAMA IM article that which I mentioned during the talk: http://archinte.jamanetwork.com/article.aspx?articleid=2301376

I think  that the MGH press release nicely summarizes the findings.

Active clinician support and assistance are critical to successfully quitting smoking

Recommending counseling, providing tobacco cessation aids can increase quit rate in high-risk patients undergoing lung cancer screening

BOSTON –Does participation in the annual lung cancer screening currently recommended for people with high-risk smoking histories encourage those who are still smoking to quit? A new study from a Massachusetts General Hospital research team (MGH) finds that the answer may depend on the level of support given by patients’primary care providers. In the report receiving online publication in JAMA Internal Medicine, the team finds that, while providers’asking such patients about smoking did not increase their likelihood of quitting, providing more direct assistance –such as talking about how to quit smoking, recommending or prescribing nicotine replacement or pharmaceutical aids, and following up on recommendations –significantly improved patients’success in becoming smoke-free.

“Our findings demonstrate the importance of clinicians’active assistance –referring patients to counseling, prescribing a stop-smoking medication, and following up to see how they are doing –in increasing the likelihood that patients will quit smoking,”says Elyse R. Park, PhD, MPH, of the MGH Tobacco Treatment Center, lead author of the study. “While all of the participants in this study had sought screening for lung cancer and their primary care physicians were aware of that screening and its results, only half of these high-risk smokers reported that their PCPs even talked to them about how to quit smoking, and even fewer received the level of help we now know can make a critical difference.”

The current report analyzed data collected in the National Lung Screening Trial (NLST), a 2011-published study that compared two screening methods –standard X-ray studies and low-dose CT screens –for early detection of lung cancer in patients with long-term smoking histories. Based on the results of that study, the U.S. Preventive Services Task Force recommended in 2013 that high-risk individuals –those aged 55 to 80 with a 30 pack-year (pack a day for a year) smoking history –receive low-dose CT screening annually, a recommendation supported by Medicare’s decision earlier this year to cover the costs of such screening for appropriate patients. But the question of whether screening participation would encourage those not receiving a lung cancer diagnosis to quit smoking had not previously been investigated.

To address that question, the research team analyzed data from assessment questionnaires completed at six-month intervals after screening by NLST participants who had not received a lung cancer diagnosis. They selected participants who had been smoking prior to screening (NLST also enrolled individuals who had quit fewer than 15 years prior to study enrollment), reported having smoked at some time during the previous six months and who had at least one visit with a primary care provider during that period. From that group they compared the 1,668 who reported they had stopped smoking since the previous assessment with an equal group who still smoked –matched by factors such as age, sex, study site and type of screening received.

Also, attached is the article

Also, attached is the article that I was discussing regarding difficulty publishing.  http://hpq.sagepub.com/content/early/2015/06/03/1359105315587136.full

Everyone – I wanted to share

Everyone – I wanted to share this paper recently published in the Journal of Community Health.  Thank you to the great leadership and guidance from CDC (Mike and Sherri) it may be helpful in building the case for CCC and Quit Lines working together.  Julia

Underwood, J.M., Hyde-Rolland, S.J., Thorsness, J. et al. J Community Health (2017). doi:10.1007/s10900-017-0341-8

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