Abstract
BackgroundSmoking cessation is a key step towards improving cancer care and outcomes. However, smoking cessation interventions are underprovided in oncology settings. Within Jordan’s only comprehensive oncology center, we sought to evaluate receipt of care at a smoking cessation clinic and the effect of assisted abstinence through the smoking cessation clinic on short-term (two-year) survival after a cancer diagnosis.MethodsWe employed a retrospective cohort study design. Cancer registry and smoking cessation clinic data for adult Jordanian cancer patients diagnosed between 2009 and 2016, who also were cigarette smokers, and who received full treatment at King Hussein Cancer Center, were analyzed. Specifically, descriptive statistics of patients who visited the smoking cessation clinic were generated, and short-term (two-year) hazard of death of patients based on whether or not smoking cessation clinic-assisted abstinence occurred, were evaluated.ResultsThere were 3403 patients who met our inclusion criteria. Approximately 21% of cancer patients were seen at the smoking cessation clinic, and significant demographic and clinical disparities in who was being seen [at the smoking cessation clinic] existed. In 2387 patients with available survival data, smokers who never went to the smoking cessation clinic (or were seen only once, or seen a year or more from diagnosis) had a hazard of death 2.8 times higher than smokers who had visited the smoking cessation clinic and who also confirmed they had not smoked on atleast two of their 3-, 6- or 12-month follow-up visits (95% confidence interval [CI] = 1.7–4.6). Non-abstainers at the smoking cessation clinic exhibited a similar disadvantage (HR 2.7, 95% CI 1.4–5.0).ConclusionsAlthough evidence-based smoking cessation interventions increase the likelihood of abstinence and can lower the short-term hazard of death during cancer treatment, there is a deprioritization of smoking cessation interventions during cancer care, as indicated by low proportions of patients seen at the smoking cessation clinic. Our findings emphasize the importance of promoting interventions to avail smoking cessation interventions in oncology settings within the cancer treatment phase.
Highlights
Smoking cessation is a key step towards improving cancer care and outcomes
Our study sought to demonstrate the value of clinicassisted abstinence in a diverse cancer patient population in Jordan, and to provide insight into which patient subgroups were at higher risk of not being seen at the smoking cessation clinic
When survival of cancer patients who received smoking cessation care was compared to that of patients who did not receive any care, our results indicated that patients who did not receive care at the smoking cessation clinic and those who did not report any abstinence despite visiting the clinic fared significantly more poorly than those who visited the clinic and reported being abstinent at more than follow-up point
Summary
Smoking cessation is a key step towards improving cancer care and outcomes. smoking cessation interventions are underprovided in oncology settings. Given the rising global burden of cancer, ensuring that cancer care is optimized and availed equitably has become an increasingly challenging priority for most countries, and resource constraints have rendered many therapeutic interventions difficult if not impossible to access [1]. In response to this global challenge, evaluating and promoting healthcare interventions that are relatively less resource-intensive and can benefit a broad range of cancer patients has become a pressing matter. More efforts are needed to draw attention to this practice gap, and more importantly to highlight the lost opportunities in improving cancer patient outcomes as a result of this gap
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