Summary
Summary: 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 yet low levels of tobacco cessation treatment referrals and patient engagement. 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.
Findings: The initial results of this QI tobacco treatment initiative demonstrate that providing comprehensive tobacco treatment services to patients within an oncology setting can result in higher tobacco treatment engagement. A tobacco treatment intervention implemented as a covered benefit of cancer care was found to be feasible and acceptable to clinicians and patients. Offered as evidence from practice-based QI evaluation, further testing of the model’s feasibility and scalability is warranted.
This study cites 2018 California Health Interview Survey (CHIS) data.
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