Recommendations for Standardization of Tobacco Use Treatment Data

Although there is widespread acceptance of the importance of assessing and treating tobacco use in cancer care settings, there is much variation in the documentation and reporting of metrics relevant to tobacco treatment. The Cancer Center Cessation Initiative (C3I), as part of the National Cancer Institute's Cancer Moonshot, convened a Metrics Standardization Workgroup to develop a data dictionary and make recommendations for standardized quality measurement, program evaluation, and tobacco treatment program development.

A multidisciplinary workgroup of 12 subject matter experts was convened to deliberate and standardize definitions for tobacco assessment and treatment utilization metrics. Decisions on which data elements to include were informed by clinical guidelines, literature reviews, and workgroup members' expertise. Consensus was reached when all members agreed that the proposed metric was clear, clinically relevant, and could be abstracted and reported.

The group considered metrics in the following categories: (1) patient identification, screening, and referral; (2) tobacco treatment process metrics; and (3) treatment outcomes. Furthermore, the group developed a tobacco screening, referral and engagement workflow, and a data library for the following terms: patient population, screening rate, tobacco use prevalence, referral rate, reach, unsuccessful reach attempts, enrollment, treatment engagement, and counseling dose. Outcome metrics (i.e., varied "quit rate" terms) were collated and defined.

The proposed standardized data definitions can be used to improve communication and measure effectiveness for tobacco use treatment, research, operational performance, policy, quality improvement, and guideline development.