WCLC 2025 - Posters & ePosters-EP.01.24 Determinants Influencing Smoking Cessation Implementation in an Oncology Setting: Canadian Healthcare Provider Perspectives

Pdf Summary

This qualitative study explores factors influencing the implementation of smoking cessation interventions in oncology settings from the perspective of healthcare providers in Ontario, Canada. Continuing to smoke after a cancer diagnosis worsens outcomes, increasing risks of secondary cancers, recurrence, poor treatment response, and toxicities. Despite the benefits of quitting, uptake of smoking cessation services remains low in cancer care.<br /><br />Researchers used purposive and snowball sampling to recruit healthcare providers from four diverse regional cancer centers, conducting four semi-structured interviews and 23 open-ended questionnaires with 27 providers representing interdisciplinary adult care teams. Using the Consolidated Framework for Implementation Research, they developed five thematic determinants affecting smoking cessation implementation:<br /><br />1. Contextual influences shape patient engagement. Patients with advanced or terminal cancers often exhibit fatalism, questioning the point of quitting smoking, reducing motivation to engage.  <br />2. Providers struggle balancing evidence and empathy; they may avoid discussing cessation with poor prognosis patients to prevent emotional distress given perceived limited benefit.  <br />3. Providers express a need for improved smoking cessation training focused on empathetic communication and substance use disorder principles.  <br />4. There is skepticism regarding opt-out referral models and timing of cessation discussions, with concerns about patient consent and information overload during initial consultations.  <br />5. Implementation is hindered by limited time during consultations, unclear roles in prescribing cessation pharmacotherapies, and insufficient feedback on providers’ cessation-related performance metrics.<br /><br />The findings highlight complex interrelated factors—patient attitudes, provider skills and beliefs, system processes—that influence smoking cessation delivery in oncology settings. Enhancing training, refining referral approaches, clarifying roles, and improving communication may optimize implementation. The study involved collaborators from University of Toronto, Centre for Addiction and Mental Health, McGill University, Ontario Health, and others, funded by the Canadian Cancer Society. Contact for principal investigator is Dr. Nadia Minian at INTREPID Lab, CAMH.

Asset Subtitle

William Evans

Meta Tag

Speaker William Evans

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

smoking cessation

oncology settings

healthcare providers

cancer care

implementation barriers

patient engagement

empathetic communication

opt-out referral models

pharmacotherapy roles

training improvement