European practice patterns and barriers to smoking cessation after a cancer diagnosis in the setting of curative versus palliative cancer treatment.
- Derksen JWG Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
- Warren GW Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
- Jordan K Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany.
- Rauh S Department of Oncology, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg.
- Vera García R Department of Medical Oncology, Complejo Hospitalario de Navarra, Pamplona, Spain.
- O'Mahony D Department of Medical Oncology, Cork University Hospital, Cork, Ireland.
- Ahmed S Department of Medical Oncology, University Hospitals of Leicester, Leicester, UK.
- Vuylsteke P Department of Medical Oncology, UCLouvain, CHU Namur, Belgium; Faculty of Medicine, University of Botswana, Gaborone, Botswana.
- Radulovic S Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
- Tsoukalas N Department of Oncology, 401 General Military Hospital of Athens, Athens, Greece.
- Wysocki PJ Department of Oncology, Jagiellonian University - Medical College, Cracow, Poland.
- Borner M Department of Medical Oncology, University Hospital Basel, Basel, Switzerland.
- Cesas A Department of Medical Oncology, Klaipeda University Hospital, Klaipeda, Lithuania.
- Elme A Department of Oncology and Hematology, North Estonia Medical Centre Foundation, Tallinn, Estonia.
- Minn H Department of Oncology, Turku University Hospital, Turku, Finland.
- Ullenhag GJ Department of Oncology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science of Life Laboratory, Uppsala University, Uppsala, Sweden.
- Roodhart JML Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
- Koopman M Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
- May AM Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address: a.m.may@umcutrecht.nl.
- 2020-09-02
Published in:
- European journal of cancer (Oxford, England : 1990). - 2020
English
BACKGROUND
Smoking cessation after a cancer diagnosis is associated with improved overall survival. Few studies have reported oncologists' cessation practice patterns, but differences between the curative and palliative settings have not been described. We aimed to study the oncologist's perceptions on patients' tobacco use, current practices and barriers to providing smoking cessation support, while distinguishing between treatment with curative (C) and palliative (P) intent.
METHODS
In 2019, an online 34-item survey was sent to approximately 6235 oncologists from 16 European countries. Responses were descriptively reported and compared by treatment setting.
RESULTS
Responses from 544 oncologists were included. Oncologists appeared to favour addressing tobacco in the curative setting more than in the palliative setting. Oncologists believe that continued smoking impacts treatment outcomes (C: 94%, P: 74%) and that cessation support should be standard cancer care (C: 95%, P: 63%). Most routinely assess tobacco use (C: 93%, P: 78%) and advise patients to stop using tobacco (C: 88%, P: 54%), but only 24% (P)-39% (C) routinely discuss medication options, and only 18% (P)-31% (C) provide cessation support. Hesitation to remove a pleasurable habit (C: 13%, P: 43%) and disbelieve on smoking affecting outcomes (C: 3%, P: 14%) were disparate barriers between the curative and palliative settings (p < 0.001), but dominant barriers of time, resources, education and patient resistance were similar between settings.
CONCLUSION
Oncologists appear to favour addressing tobacco use more in the curative setting; however, they discuss medication options and/or provide cessation support in a minority of cases. All patients who report current smoking should have access to evidence-based smoking cessation support, also patients treated with palliative intent given their increasing survival.
Smoking cessation after a cancer diagnosis is associated with improved overall survival. Few studies have reported oncologists' cessation practice patterns, but differences between the curative and palliative settings have not been described. We aimed to study the oncologist's perceptions on patients' tobacco use, current practices and barriers to providing smoking cessation support, while distinguishing between treatment with curative (C) and palliative (P) intent.
METHODS
In 2019, an online 34-item survey was sent to approximately 6235 oncologists from 16 European countries. Responses were descriptively reported and compared by treatment setting.
RESULTS
Responses from 544 oncologists were included. Oncologists appeared to favour addressing tobacco in the curative setting more than in the palliative setting. Oncologists believe that continued smoking impacts treatment outcomes (C: 94%, P: 74%) and that cessation support should be standard cancer care (C: 95%, P: 63%). Most routinely assess tobacco use (C: 93%, P: 78%) and advise patients to stop using tobacco (C: 88%, P: 54%), but only 24% (P)-39% (C) routinely discuss medication options, and only 18% (P)-31% (C) provide cessation support. Hesitation to remove a pleasurable habit (C: 13%, P: 43%) and disbelieve on smoking affecting outcomes (C: 3%, P: 14%) were disparate barriers between the curative and palliative settings (p < 0.001), but dominant barriers of time, resources, education and patient resistance were similar between settings.
CONCLUSION
Oncologists appear to favour addressing tobacco use more in the curative setting; however, they discuss medication options and/or provide cessation support in a minority of cases. All patients who report current smoking should have access to evidence-based smoking cessation support, also patients treated with palliative intent given their increasing survival.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1016/j.ejca.2020.07.020
- PMID 32871527
- Persistent URL
- https://sonar.ch/global/documents/73875
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