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Implementing a smoking cessation initiative in a cancer program: A quality improvement project
Patsy Astarita1, Diane Fitzgerald1
1Oncology Services/Kaufman Cancer Center, University of Maryland, Upper Chesapeake Health, Bel Air, MD.
Surgery
|May 26, 2026
Summary
A smoking cessation program for cancer patients achieved a 100% screening rate. Over half of patients receiving quit kits reduced tobacco use, despite challenges in implementation and varying assistance rates.
Area of Science:
- Oncology
- Public Health
- Behavioral Science
Background:
- Higher smoking rates in Harford County necessitated improved smoking cessation support for cancer patients.
- Identified gaps in provider-patient communication regarding smoking status and cessation readiness.
- Smoking cessation integrated as a primary treatment modality, aligning with Commission on Cancer initiatives.
Purpose of the Study:
- To integrate a smoking cessation support program into routine care for newly diagnosed cancer patients.
- To systematically identify, intervene with, and refer patients who smoke.
- To address local disparities in smoking rates and cessation resources.
Main Methods:
- Implemented a standardized 2-question screening in the electronic medical record (EMR) workflow for all new cancer patients.
- Utilized medical assistants and nurses for intake screening, providing "quit kits" and referrals for patients ready to quit.
- Employed certified facilitators for follow-up phone support, education, and motivational interviewing.
Main Results:
- Achieved a 100% smoking status "ask rate" via mandatory EMR hard stop among 667 new patients.
- Reported "assist rates" for active smokers fluctuating between 35% and 54%.
- Over 50% of patients receiving quit kits reported reduced or discontinued tobacco use.
Conclusions:
- Despite challenges like EMR limitations and competing priorities, executive support and collaboration were crucial.
- Ongoing efforts aim to optimize EMR integration, enhance staff education, and expand cessation support.
- The initiative demonstrated progress in addressing smoking cessation within cancer care despite implementation barriers.
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