Sustainability of Tobacco Treatment Programs in the Cancer Center Cessation Initiative
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The NCI’s Cancer Center Cessation Initiative (C3I) has a specific objective of helping cancer centers develop and implement sustainable programs to routinely address tobacco cessation with patients. Sustaining tobacco treatment programs requires the maintenance of (1) core program components, (2) ongoing implementation strategies, and (3) program outcomes evaluation. NCI funding of C3I included a commitment of resources toward sustainability. This article presents case studies to illustrate key strategies in developing sustainability capacity across 4 C3I-funded sites. Case studies are organized according to the domains of sustainability capacity defined in the Clinical Sustainability Assessment Tool (CSAT). We also describe the C3I Sustainability Working Group agenda to make scientific and practical contributions in 3 areas: (1) demonstrating the value of tobacco use treatment in cancer care, (2) identifying implementation strategies to support sustainability, and (3) providing evidence to inform policy changes that support the prioritization and financing of tobacco use treatment. By advancing this agenda, the Sustainability Working Group can play an active role in advancing and disseminating knowledge for tobacco treatment program sustainability to assist cancer care organizations in addressing tobacco use by patients with cancer within and beyond C3I.
Cancer Center Cessation Initiative Sustainability Working Group
Ramzi G. Salloum PhD1, Linda Fleisher PhD, MPH2, Sarah D. Hohl MPH, PhD3, Sarah V. Clark BA4, Elizabeth Klass RN, BSN4, Neely A. Dahl MPH5, Brittany Pike MS, RN6, Katie L. Lenhoff MPH7, Cary A. Presant MD, FACP, FASCO8, Kimberly A. Shoenbill MD, PhD9, Alex T. Ramsey PhD10, Thulasee Jose MD11, Andrew T. Day MD, MPH12, Michael Dark MPH13, Sophia Yeung MHA8, Elisa K. Tong MD14, Judith J. Prochaska PhD6, Jamie S. Ostroff PhD15, Donna Shelley MD, MPH16, Graham W. Warren MD, PhD17, Robert Adsit MEd18, Mara Minion MA3, Danielle Pauk BS3, and Betsy Rolland PhD, MLIS, MPH3,19
1 Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, and University of Florida Health Cancer Center, Gainesville, Florida; | 2 Fox Chase Cancer Center, Philadelphia, Pennsylvania; | 3 Carbone Cancer, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; | 4 Department of Preventive Medicine, Feinberg School of Medicine, and Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois; | 5 University of Virginia Cancer Center, Charlottesville, Virginia; | 6 Stanford Cancer Institute, Stanford, California; | 7 Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire; | 8 Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, and Beckman Research Institute, Duarte, California; | 9 Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; | 10 Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri; | 11 Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota; | 12 Department of Otolaryngology – Head and Neck Surgery, University of Texas Southwestern Medical Center, and Simmons Comprehensive Cancer Center, Dallas, Texas; | 13 Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, Maryland; | 14 Department of Internal Medicine; University of California Davis Comprehensive Cancer Center, Sacramento, California; | 15 Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York; | 16 Department of Public Health Policy and Management, and Global Center for Implementation Science, New York University School of Global Public Health, New York, New York; | 17 Department of Radiation Oncology, and Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina; | 18 Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and | 19 Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, Wisconsin.
Submitted July 26, 2021; final revision received September 14, 2021; accepted for publication September 16, 2021.
Disclosures: E.K. Tong has disclosed participating in research for the California Tobacco Control Program (Principal Investigator). J.J. Prochaska has disclosed serving on a data safety monitoring board for Achieve Life Science, serving on an advisory board for Carrot, acting as plaintiffs' expert witness in lawsuits against tobacco companies, and owning stock in Carrot. G.W. Warren has disclosed participating in research for the Agency for Healthcare Research and Quality and serving as a consultant for the Canadian Partnership Against Cancer. The remaining individuals have disclosed no relevant financial relationships.
Funding: This supplement was funded by the C3I Coordinating Center contract from the National Cancer Institute (CRDF Award #66590). In addition, authors received funding for their C3I participation via a supplement to their NCI P30 cancer center support grant during the period 2017–2021.
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