To describe treatment engagement and outcomes of patients who smoke with cancer and received tobacco cessation treatment during hospitalization.
We analyzed treatment engagement and cessation outcomes for hospitalized patients who smoke with a current or former history of cancer receiving treatment from an inpatient tobacco treatment service between July, 2018 to October, 2019.
The service treated 407 inpatients. Patients had an overall high level of interest in quitting (7.6, 0–10 scale). One in three accepted cessation pharmacotherapies during hospitalization or at discharge (35%) and/or referral to the state tobacco quitline (37%). Of 189 patients reached at one-month post-discharge, 73 (39%) reported tobacco abstinence (18% intent to treat—ITT—quit rate); 35.5% had used cessation pharmacotherapy and 6.5% had engaged in quitline counseling. Of 151 patients reached at 6 months post-discharge, 29% reported abstinence (11%, ITT).
Inpatients with a history of cancer are interested in quitting. Post-discharge quit rates and pharmacotherapy use were high but quitline use was low. Hospitalization is an under-utilized, prime treatment opportunity and teachable moment for people with a history of cancer who continue to use tobacco.
- • Tobacco users with a current or former history of cancer admitted to the hospital show interest in quitting.
- • Post-discharge tobacco cessation pharmacotherapy and quit rates were high.
- • Post-discharge quitline utilization was low and efforts are needed to increase post-discharge behavioral support.
- • Hospitalization is a prime treatment opportunity for people with a history of cancer who continue to use tobacco.
Quitting smoking improves cancer prognosis, reduces side effects from cancer treatments, and improves wound healing . The efficacy of cessation intervention among patients with tobacco use diagnosed with cancer is well-established , but these patients often receive no assistance in quitting .
Most cessation interventions focus on outpatient cancer care, but hospitalization is a teachable moment and prime opportunity to initiate treatment for people with cancer who smoke. In 2014, there were an estimated 461,295 tobacco-related cancer hospitalizations in the U.S which accounted for 45% of all cancer-related hospitalizations and had a longer average length of stay (6.8 days) compared to non-cancer hospitalizations (5.7 days) .
We know little about treating tobacco dependence among inpatients with cancer. In general, combined behavioral and pharmacotherapy interventions double quit rates. Interventions in hospitals increase quit rates by 37% . Few hospitals provide systematic tobacco treatment perhaps because there are no required quality measures, Centers for Medicaid and Medicare rules, or links to payment for inpatient tobacco treatment . Two pilot studies describe inpatient cessation interventions, focused on surgical oncology patients . The purpose of this study was to describe treatment engagement and outcomes among patients with any history of cancer who received tobacco treatment during their hospitalization.