A SYSTEMATIC APPROACH TO SMOKING CESSATION IN REGIONAL CANCER CENTRES IN ONTARIO, CANADA
W.K. Evans1, E. Cameron1, M. Haque1, N. Schwartz1, S. Khan1, D. Saunders2, R. Truscott1
1Cancer Care Ontario, Population Health & Prevention, Toronto, Canada
2Health Sciences North, North East Cancer Centre, Sudbury, Canada
Introduction:
Cancer patients who continue to smoke gain less benefit from treatments, experience greater toxicities, and are at increased risk of cancer recurrence, second primaries and mortality. Despite awareness of these negative health consequences of continued smoking, a systematic approach to help cancer patients quit smoking is uncommon.
Methods:
In 2012, Cancer Care Ontario (CCO) established a Framework for smoking cessation across all 14 regional cancer centres (RCCs) in Ontario, Canada. The Framework included: implementing the 5As (Ask, Advise, Assess, Assist, Arrange) model; recruitment of regional
champions to promote the program; and centralized data collection and reporting. Tobacco Use Screening rates became a performance metric to drive implementation and were reviewed quarterly with leadership. During 2014/15, just over 50% of cancer
patients were screened for tobacco use. Efforts to improve performance included transitioning to the 3As (Ask, Advise, Act) model, monitoring “Accepted a Referral” rates as a performance metric, and use of an “opt-out” approach to referrals (where tobacco users are automatically referred unless they refuse). An environmental scan and site visits resulted in RCC-specific improvement plans.
Results:
The majority of RCCs are exceeding the Tobacco Use Screening target of 75%, but the proportion of smokers who Accepted a Referral remains low. The opt-out approach is anticipated to increase referral rates, and preliminary data are encouraging.
Conclusions:
To improve program efficiency and impact, CCO’s smoking cessation initiative adopted a 3As model and an opt-out referral process.
Early results show a promising increase in the proportion of smokers accepting referrals to cessation services.
No conflict of interest