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O06 - Cancer Control and Epidemiology I (ID 135)
- Event: WCLC 2013
- Type: Oral Abstract Session
- Track: Prevention & Epidemiology
- Presentations: 1
O06.05 - Multidisciplinary smoking cessation model in a specialist oncology hospital - our 5 year experience (ID 2106)
10:30 - 12:00 | Author(s): I. Plueckhahn
Australia established its first national quitline service in 1997 as part of the Australian National Tobacco Campaign (NTC). In 2005 our hospital, an Australian tertiary specialist cancer centre, commenced a multidisciplinary smoking cessation program which included the provision of counselling and behaviour techniques as well as free access to pharmacological smoking cessation agents. In 2007 the hospital went totally smoke free and in 2009 all new patient registrations included collection of information pertaining to smoking behaviours. Cancer patients are known to withhold and underreport details regarding current and previous smoking behaviours however there is limited data on the impact of non-disclosure on the ability to implement interventional smoking cessation programs in the oncology setting. Five years after initiation of an interventional smoking cessation program we present previously uncollected and unreported hospital wide smoking behaviour data (prevalence, magnitude and willingness to report) of cancer patients. We also evaluate our multidisciplinary smoking cessation model including recruitment and quit rates for cancer patients at a specialist oncology centre.
For the two year period 2009-2011 self-reported smoking behaviors were obtained from hospital registration datasets. A retrospective single arm cohort study, including patients with a cancer diagnosis who accessed the smoking cessation program within the same two year period, was also conducted. Patients and family members are recruited to the program via a multidisciplinary referral system and have access to nurse led counselling and behaviour modification consultations as well as provision of free pharmacological smoking cessation aids. Evaluation of the program was undertaken through and audit of medical and pharmacy records for all patients who participated in the program (n=312) and by phone interviews with a subset of patients (n=30) and compared to data from a previously published study at our institution.
50% (n=10,401) of patients newly registered to the hospital identified as having ever smoked with 12% (n=2448) current smokers. Recruitment of self-identified active smokers into the smoking cessation program was low (7.3%). 43% (n=134) of patients enrolled into the program had not disclosed their smoking status at hospital registration. Magnitude of smoking was high; average pack-years of patients who have ever smoked was 22.6 and for current smokers was 27.8; 155 patients reported smoking magnitude as greater than 100 pack years. Provision of free pharmacotherapy equated to a net expenditure of AUD$22,042. Point prevalence smoking cessation rate among patients who participated in follow-up interviews (n=30) was similar to that previously reported following participation in our multidisciplinary smoking cessation program, 33% compared to 37%. 66% of patients reported successful outcomes (cessation or reduction in consumption).
Patient-reported smoking behaviours were grossly underreported impacting on the ability to actively enrol patients into established interventional cessation programs. Despite low recruitment rates and high magnitude of smoking, the multidisciplinary model was able to achieve successful outcomes at minimal cost in this vulnerable patient cohort. Improving disclosure practices may enable future targeted recruitment of patients by health-care professionals and increase the participation of smokers in proven healthcare interventions.
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