Abstract LB553: Empowering tobacco using cancer patient initiation of tobacco cessation by a personal pathway to success program during preoperative patient counseling: A feasibility study
Authors: Presant Cary A. , Ashing Kimlin , Yeung Sophia , Macalintal Jonjon , Gascon Brenda , Sandoval Argelia , Tiep Brian , Cianfrocca Mary , Salgia Ravi , Raz Dan , Erhunmwunsee Loretta , Fong Yuman , Rosen Steven 
Published: June 2022

Abstract
Background: Cancer patients who use tobacco often decline to participate in structured tobacco cessation programs. and personal barriers and priorities vary. To overcome barriers and improve pt engagement, we constructed a Personal Pathway to Success (PPS) program which enabled patients to choose cessation components they could effectively use.
Methods: City of Hope (COH) constructed a comprehensive list of cessation tools. Patients completed tobacco use and Lifestress social domain stress assessments. PPS was then proposed to patients who selected tools they would initially use in quit attempts. Pts could add or delete tools at any time but were encouraged to add likely effective tools. Since tobacco use is associated with adverse surgical outcomes, the PPS program was pilot tested at the preoperative anesthesia testing clinic (PATC). Patients were evaluated for acceptance of cessation and follow through with counseling. Results were compared by Chi square statistic to pt cessation results before PPS program implementation. Study data collection was 9/11/21 to 1/3/22.Results: The tools in PPS were Individual cessation counseling, nicotine replacement and cessation medications, signed personal commitment agreement, cessation support group, choosing a buddy partner (family, friends or support group), lung cancer screening, letter to primary care physicians requesting assistance for non-responding patients, SmokeFree Text support, Kick It California or Asian Quitline support, rapid action plan for relapses, 5Ds cessation and 7 self-care skills, COH relaxation and/or hypnosis videos, guidance for cinnamon stick/bubble blowing, stress management and smoking cessation apps, cessation videos and audios, educational brochures, advice on vaping, assistance with internet and digital devices, family education and support, and psycho-social or substance abuse referrals. At PATC 36 evaluable patients were offered the PPS program, counseling and/or video education. Nineteen patients (53%) agreed to cessation, 14 (74%) scheduled a definite date for counseling. 42% completed the counseling. Video education was watched by 6 (32%) patients. Thirty two % had future appointments, but 26% had not yet scheduled. Three patients (8%) desired more time to evaluate cessation. Fourteen patients did not respond despite 3 attempts and were referred back to their attending physician. Compared to results pre-PPS, patient initiation was increased from 8.7% to 53% (p&lt;.001).
Conclusions: The Personal Pathway to Success program empowered patients to select among different cessation tools and increased pt acceptance of cessation. Offering comprehensive tobacco cessation during cancer surgery pre-anesthesia visits represents a teachable moment when patients are more motivated to accept behavioral interventions and tobacco cessation. Further research will develop additional methods to further increase engagement of hard to reach patients, family and caregivers.
Citation Format: Cary A. Presant, Kimlin Ashing, Sophia Yeung, Jonjon Macalintal, Brenda Gascon, Argelia Sandoval, Brian Tiep, Mary Cianfrocca, Ravi Salgia, Dan Raz, Loretta Erhunmwunsee, Yuman Fong, Steven Rosen. Empowering tobacco using cancer patient initiation of tobacco cessation by a personal pathway to success program during preoperative patient counseling: A feasibility study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB553.