Implementation of tobacco cessation services at a comprehensive cancer center: a qualitative study of oncology providers
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ORIGINAL ARTICLE
Implementation of tobacco cessation services at a comprehensive cancer center: a qualitative study of oncology providers’ perceptions and practices Samuel N. Rodgers-Melnick 1,2
&
Monica Webb Hooper 3,4
Received: 14 July 2020 / Accepted: 4 September 2020 # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract Purpose To explore (1) perceptions of tobacco cessation for patients, (2) perceived role in addressing patients’ tobacco use, (3) facilitators and barriers to providing cessation services, and (4) perceptions and use of tobacco cessation resources among oncology providers. Methods Interviews were conducted with 24 oncology providers at a National Cancer Institute-Designated Comprehensive Cancer Center. Qualitative themes were analyzed using content analysis. Results Participants (1) perceived smoking cessation’s priority as low and/or dependent upon clinical factors, (2) described a passive role in addressing tobacco cessation, (3) described loss-framed versus gain-framed messaging when delivering cessation advice, (4) reported moderate self-efficacy in discussing and low self-efficacy in implementing cessation strategies, (5) described multi-level facilitators and barriers to patients’ tobacco cessation, and (6) expressed high value for the cancer center’s tobacco cessation service. Conclusion Oncology providers in this study perceived patients’ tobacco cessation as a low priority relative to providing direct cancer treatment and addressing acute complications. These findings indicate opportunities for training to increase delivery of evidence-based cessation advice and facilitate patients’ engagement in cessation services. Provider trainings on embracing an active role in tobacco cessation, addressing multi-level barriers to patients’ tobacco cessation, and using gain-framed messaging should be implemented. This has the potential to improve cancer patients’ treatment outcomes. Keywords Smoking cessation . Cancer patients . Healthcare providers . Qualitative research
Introduction For several decades, tobacco use has been known to influence the development of multiple cancers [1]. Tobacco use also
* Monica Webb Hooper [email protected] 1
Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106, USA
2
University Hospitals Connor Integrative Health Network, 11100 Euclid Ave, Cleveland, OH 44106, USA
3
Case Comprehensive Cancer Center, Case Western Reserve University, 2103 Cornell Rd, Cleveland, OH 44106, USA
4
National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, USA
confers negative effects on the cancer treatment process, including decreased survival, increased recurrence of disease, decreased treatment efficacy, increased complications, and poorer quality of life [2, 3]. These findings have led organizations includ
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