We need to be able to treat the whole patient, not just his or her cancer.
—Carolyn Dresler, MD
It is well recognized that tobacco use increases the risk of several kinds of cancer. However, it is less well recognized that quitting tobacco remains important once an individual has been diagnosed with cancer, a common misconception held by oncologists and patients alike. Patients with cancer who continue to use tobacco have poorer treatment outcomes compared to their counterparts who stop using tobacco, a finding that seems to occur in patients with many different types of cancer, regardless of whether the cancer was tobacco related. The good news is that quitting can have health benefits and evidence-based interventions to support quit efforts are available.
“Many people have the idea that if you have a diagnosis of cancer, there are a lot more important things to be worried about than whether you smoke or not—but we need to change that,” said K. Michael Cummings, PhD, Professor in the Department of Psychiatry & Behavioral Sciences at the Medical University of South Carolina Hollings Cancer Center and long-time researcher on tobacco control, public policy, and tobacco cessation.
The first step, said Dr. Cummings, is for health providers to be able to communicate effectively with patients about quitting tobacco in ways that remove the stigma that has for years been affixed to tobacco use, and then to equip providers with effective ways of helping patients quit.
To this end, ASCO has created a new set of resources on tobacco cessation for patients and providers in the oncology setting. The resources, published earlier this month, are available online at asco.org as well in print format.
Tobacco Cessation Guide for Oncology Providers
The Tobacco Cessation Guide for Oncology Providers is an evidence-based tobacco cessation resource for providers to use in educating their patients about the negative effects of tobacco on cancer treatment outcomes and to help patients quit. Developed by a multidisciplinary group of cancer and tobacco cessation experts, this guide is intended to help oncology providers integrate tobacco cessation strategies into their practices.
An important goal of the provider guide is to help oncologists and other oncology providers become more comfortable in addressing the topic of tobacco use with their patients.
“Physicians, including oncologists, do not know how to help their patients quit. We need to help them help their patients,” said Carolyn Dresler, MD, Associate Professor of Health Policy and Management in the Fay W. Boozman College of Public Health at the University of Arkansas, Tobacco Control Branch Chief at the Department of Health and Human Services for the state of Arkansas, and Chair of ASCO’s Tobacco Cessation and Control Subcommittee. “We need to be able to treat the whole patient, not just his or her cancer.”
The provider guide offers practical tips on how to incorporate tobacco assessment and treatment into the routine practice of oncology as well as how to be reimbursed for these services. It includes updated listings for state quitlines and websites such as www.smokefree.gov. In doing so, the guide does not endorse any one treatment for quitting, but rather emphasizes providing a personalized plan for individual patients. ASCO hopes that the resources contained within the guide will be used by all oncology providers whose patients use tobacco, including medical oncologists, nurses, physician assistants, psychosocial providers, and primary care providers who see cancer patients in their practice.
Guidance for Patients and Families
As a complement to the provider guide, ASCO has also published a guide to help educate patients and their caregivers on the benefits of quitting tobacco use. The patient guide offers a quitting assessment tool, a place to develop a plan to quit, and a list of quitlines, websites, and mobile apps to help patients stop tobacco use. It can be found at www.cancer.net/tobacco.
The guide for patients and families emphasizes that, although it can be difficult, many people are successful at quitting tobacco use, and a variety of treatment options and resources exist to help people reach their goal. The booklet provides individuals with clear, practical information about the benefits of stopping tobacco use after a cancer diagnosis, and tips for how patients can talk with their doctors about stopping tobacco use.
Both the provider guide and patient booklet will be available to order through the ASCO University Bookstore (http://store2.asco.org/) for your practice, either as a package of 10 provider guides and 115 patient booklets, or 125 patient booklets. ■
© 2012. American Society of Clinical Oncology. All Rights Reserved.