Addressing Tobacco Use in Patients With Cancer: A Survey of American Society of Clinical Oncology Members

Copyright © 2013 by American Society of Clinical Oncology

Addressing Tobacco Use in Patients With Cancer: A Survey of American Society of Clinical Oncology Members

1. Graham W. Warren, MD, PhD⇑,
2. James R. Marshall, PhD,
3. K. Michael Cummings, PhD, MPH,
4. Benjamin A. Toll, PhD,
5. Ellen R. Gritz, PhD,
6. Alan Hutson, PhD,
7. Seyedeh Dibaj, MS,
8. Roy Herbst, MD,
9. James L. Mulshine, MD,
10. Nasser Hanna, MD and
11. Carolyn A. Dresler, MD, MPA

+ Author Affiliations

1. Medical University of South Carolina, Charleston, SC; Roswell Park Cancer Institute, Buffalo, NY; Yale School of Medicine, Yale Cancer Center, New Haven, CT; University of Texas MD Anderson Cancer Center, Houston, TX; Rush University, Chicago, IL; Indiana University School of Medicine, Indianapolis, IN; and Arkansas Department of Health, Little Rock, AR

1. Corresponding author: Graham W. Warren, MD, PhD, Department of Radiation Oncology, Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, 169 Ashley Ave, Charleston, SC 29425; e-mail: Warrengw@musc.edu.

Abstract

Purpose: Assessing tobacco use and providing cessation support is recommended by the American Society for Clinical Oncology (ASCO). The purpose of this study was to evaluate practice patterns and perceptions of tobacco use and barriers to providing cessation support for patients with cancer.

Methods: In 2012, an online survey was sent to 18,502 full ASCO members asking about their practice patterns regarding tobacco assessment, cessation support, perceptions of tobacco use, and barriers to providing cessation support for patients with cancer. Responses from 1,197 ASCO members are reported.

Results: At initial visit, most respondents routinely ask patients about tobacco use (90%), ask patients to quit (80%), and advise patients to stop using tobacco (84%). However, only 44% routinely discuss medication options with patients, and only 39% provide cessation support. Tobacco assessments decrease at follow-up assessments. Most respondents (87%) agree or strongly agree that smoking affects cancer outcomes, and 86% believe cessation should be a standard part of clinical cancer care. However, only 29% report adequate training in tobacco cessation interventions. Inability to get patients to quit (72%) and patient resistance to treatment (74%) are dominant barriers to cessation intervention, but only 8% describe cessation as a waste of time.

Conclusion: Among ASCO members who responded to an online survey about their practice patterns regarding tobacco, most believe that tobacco cessation is important and frequently assess tobacco at initial visit, but few provide cessation support. Interventions are needed to increase access to tobacco cessation support for patients with cancer.