Bridging the Gap: Integrating Tobacco Cessation into Cancer Care

Abstract

Evidence-based practice is an expectation in healthcare. However, practicing in this manner is not always achievable. This can lead to gaps between what is known to be best practice and what is actually done. Tobacco cessation in cancer care is a good example of this kind of gap. Tobacco use can render treatment less effective and can have a negative impact on outcomes. Despite this knowledge, many patients continue to use tobacco after their diagnosis and during treatment. Knowledge to Action (KTA) frameworks are beneficial in closing knowledge gaps by aiding in implementing and sustaining evidence-based practices and policies. It is the goal of this study to identify the barriers to tobacco cessation within the local context of this center and use this information in conjunction with a KTA framework to form a successful and sustainable tobacco cessation model. Radiation oncologists, radiation therapists, and radiation oncology nurses were invited to participate in uniprofessional focus groups and semi-structured interviews. Questions regarding barriers to providing cessation support were used to help guide the discussions. Audio recordings were taken of each group and interview and transcribed verbatim. These transcripts were analyzed by a coding process which was utilized to identify themes within the data. Information gathered from a local tobacco cessation working group and a review of tobacco cessation processes in neighbouring provinces was used to support the data from this study. Insufficient recourses and unclear roles and responsibilities were the main themes identified in the data by all three professional groups. Data from the provincial working group and neighbouring centers showed a large variation in tobacco cessation practices. The consequences of continued tobacco use during cancer treatment highlights the need for a tobacco cessation model within our department. Identifying the barriers to tobacco cessation within the context of this center and applying the information to a knowledge to action framework outlined a plan for the development of a tobacco cessation model. This framework also outlined methods to evaluate this model, monitor its use, and propose ways to ensure its sustainability. The goal of this process is to ensure that our patients are receiving care based on the best available evidence.