P1.10-09 Cessation Rates of an Expanded Pharmacy-Driven Smoking Cessation Program

Abstract

In the United States, smoking accounts for approximately one-third of all cancer related deaths. While national oncology organizations advocate smoking cessation integrated into cancer management, only 30-40% of oncologists provide assistance with quitting. Barriers to providing this service are well documented. Pharmacy learners are positioned to provide this intervention with the incorporation of smoking cessation therapies in accredited PharmD curricula. Previous pharmacist-driven programs reported 30-day quit rates of 23%. The purpose of this study is to characterize the smoking cessation rates of a pharmacy-driven smoking cessation program for upper-aerodigestive cancer patients or patients with a pulmonary precancerous diagnosis. Patients seen in a multidisciplinary upper aerodigestive clinic between April 2017 and July 2018 were screened. All active smokers and former smokers, who quit in the last 90 days, were eligible and offered enrollment in the program. The primary endpoint is to describe participant’s quit-rates at 30, 90, and 180-days and number of patients who abstained from smoking from 30 to 90 days and 30 to 180 days. Tobacco use assessments and smoking cessation counseling were performed and documented by a pharmacy learner (pharmacy resident or student). A licensed pharmacist oversaw learner activity and documentation. Nicotine replacement therapy was provided immediately to eligible participants in a dose based on tobacco use. Participants received follow up via phone or in clinic every two weeks for the first three months, at six, nine, and twelve months of program enrollment. Two follow up phone call attempts were made at each time point to determine if not successfully reached. Seventy-seven patients were enrolled in the pharmacy-driven smoking cessation program. The majority of patients were male, 52% (40), and younger than 65 years old, 56% (43). Patient-reported smoking cessation rates at 30-days, 90-days, and 180-days post enrollment were 38% (29), 38% (29), and 30% (23), respectively. Sustained quit-rate from 30-90 days was 29% (22). Sustained quit-rate from 30-180 days was 20% (15). At one, three, and six months, 4%, 9%, and 26% of patients, respectively, were unavailable by phone. Thirty percent of participants were successful in smoking cessation at 180 days from program enrollment, which compares favorably to previous pharmacist interventions. Telephone follow up continues to be challenging, especially later in the program. Future efforts will compare pharmacy-driven smoking cessation program to standard of care smoking cessation efforts and explore impacts of smoking cessation on clinical outcomes in patients who are receiving cancer care.