Trends in assessing and offering tobacco treatment to support persons as part of cancer care.
Authors: Crane Tracy E. , Minion Mara M. , Hohl Sarah D. , Shoenbill Kimberly , Peregoy Jennifer A. , Goldstein Adam , Park Elyse R. , Warren Graham W. , Tsoh Janice Y. 
Published: June 2022

e13542

Background: Individuals from the family and social support network of cancer patients can have a pivotal role in reinforcing patients’ efforts to become and remain tobacco-free. This support is critical along the entire continuum of cancer care. While NCI-designated cancer centers across the US are increasingly offering tobacco cessation services, as a result of the NCI Cancer Center Cessation initiative, engaging patients’ family and other support network in tobacco treatment is not yet routine practice and has not been well described. We present findings from NCI designated cancer centers on the practice of assessing and offering tobacco treatment to support persons as part of care. Methods: A 24-item survey was administered (July-August 2021) across 50 cancer centers participating in C3I. Questions focused on the practice of routine assessment, offering information on quitting, referral to tobacco treatment, involving the family and social support person in tobacco treatment, provide tobacco treatment and document treatment for support persons of cancer patients. Responses assessed frequency of these practices, which included “never,” “rarely,” “sometimes,” “always (routine),” and “don’t know”. Additionally, strength of support from leadership for these practices and program access to linguistic and culturally appropriate resources were assessed using responses “not at all,” “some,” “great,” “full extent” and “don’t know”. Descriptive statistics were performed using SPSS (V. 28). Results: Representatives from 45 centers (90%) completed the survey. Less than half of centers (44%) indicated they always identified and 29% always offered resources to patients’ support persons or family members who used tobacco. Fewer clinics (18%), always provided treatment to patients’ support persons or family members and only one reported billing for tobacco use treatment encounters with support persons. For patient’s secondhand smoke exposure, less than half of the clinics report routinely (always) assessing (44%), documenting (49%) and providing intervention (29%). Importantly, 60% of centers reported having access to linguistically and culturally appropriate, population-specific resources to address support persons tobacco use to a great or full extent. Leadership support to address family and support persons’ tobacco use was indicated by 56% of clinics. Conclusions: While some NCI designated cancer centers report routine practices for patients’ support persons, including family members who use tobacco, there is substantial room for improvement. The importance of routine practices to assess and treat support persons who use tobacco can dramatically improve tobacco cessation and ultimately overall outcomes for cancer patients. Similarly, addressing secondhand smoke exposure for cancer patients and their support person(s) who smoke, is critical along the entire continuum of cancer care.