Sustainment of Tobacco Use Treatment Programs Across National Cancer Institute-Designated Cancer Centers

Though tobacco use treatment (TUT) after a cancer diagnosis can improve cancer treatment outcomes and survival, delivery of evidence-based TUT remains underutilized in cancer care. The National Cancer Institute (NCI) Cancer Center Cessation Initiative (C3I) implemented TUT across 52 NCI-Designated Cancer Centers, but there is little information on its long-term sustainment. This study assesses TUT sustainment beyond initial implementation in C3I.

A web-based survey across 52 C3I centers was conducted during the sustainment phase (2023-2024) following NCI C3I funding. The surveys assessed program funding and the sustainment of the overall program, program components and practices, assessment of implementation and patient outcomes, partnerships, and program scale-out across settings. The survey data were analyzed using descriptive statistics.

Among 47 responding sites (90% response rate), 83% reported continued TUT activity after NCI funding ended with annual operating budgets between $100,000 and $250,000. Most sites (78.7%) reported some institutional support, while few relied on fee-for-service reimbursement (27.7%), bundled payments (8.1%), or support from grants (27.7%) and philanthropic donations (21.3%). Key program components including electronic health record modifications, outcomes reporting, and staff training were largely maintained, with nearly all (46) sites continuing to screen for tobacco use and refer patients to TUT. Perceived program partnerships were strongest with clinicians and departmental leadership, and some programs were scaled out to primary care and other specialties.

Results confirm that most cancer centers sustained key TUT program functions and partnerships with some increasing TUT delivery across larger cancer treatment settings.