Implementation of a comprehensive smoking cessation program in cancer care

Area of Science:

• Oncology
• Digital Health
• Public Health

Background:

• Quitting smoking post-cancer diagnosis significantly improves treatment efficacy, prognosis, and quality of life.
• Smoking cessation services are often not integrated into routine cancer care pathways.
• The Princess Margaret Cancer Centre introduced a digital smoking cessation program within oncology.

Purpose of the Study:

• To describe the implementation of a digitally-based smoking cessation program in a high-volume cancer center.
• To outline a practice blueprint for integrating smoking cessation into standard cancer care.
• To leverage an e-referral system for screening and referral.

Main Methods:

• Adopted the Framework for Managing eHealth Change for program implementation.
• Integrated the cease e-referral system into existing electronic patient assessments.
• Utilized stakeholder engagement, workflow analysis, and clinic audits for integration and evaluation.

Main Results:

• Screened 13,617 of 22,137 eligible new patients (62%) between April 2016 and March 2018.
• Identified 1382 current smokers (10%) and 532 recent quitters (4%).
• Referred 380 patients (20%) to smoking cessation counseling services.

Conclusions:

• Digitally-based smoking cessation programs can be effectively implemented as standard care in comprehensive cancer centers.
• The study provides a blueprint for integrating such programs in high-patient-volume settings.
• Successful integration requires a structured approach, stakeholder buy-in, and robust evaluation.