Telehealth Delivery of Tobacco Cessation Treatment in Cancer Care: An Ongoing Innovation Accelerated by the COVID-19 Pandemic
Search for other papers by The Cancer Center Cessation Initiative Telehealth Working Group in
Current site
Google Scholar
PubMed
The COVID-19 pandemic precipitated a rapid transformation in healthcare delivery. Ambulatory care abruptly shifted from in-person to telehealth visits with providers using digital video and audio tools to reach patients at home. Advantages to telehealth care include enhanced patient convenience and provider efficiencies, but financial, geographic, privacy, and access barriers to telehealth also exist. These are disproportionately greater for older adults and for those in rural areas, low-income communities, and communities of color, threatening to worsen preexisting disparities in tobacco use and health. Pandemic-associated regulatory changes regarding privacy and billing allowed many Cancer Center Cessation Initiative (C3I) programs in NCI-designated Cancer Centers to start or expand video-based telehealth care. Using 3 C3I programs as examples, we describe the methods used to shift to telehealth delivery. Although telephone-delivered treatment was already a core tobacco treatment modality with a robust evidence base, little research has yet compared the effectiveness of tobacco cessation treatment delivery by video versus phone or in-person modalities. Video-delivery has shown greater medication adherence, higher patient satisfaction, and better retention in care than phone-based delivery, and may improve cessation outcomes. We outline key questions for further investigation to advance telehealth for tobacco cessation treatment in cancer care.
The Cancer Center Cessation Initiative Telehealth Working Group
Nancy A. Rigotti MD1, Kathryn L. Taylor PhD2, Diane Beneventi PhD3, Andrea King PhD4, Chris Kotsen PsyD, NCTTP5, Linda Fleisher PhD, MPH6, Adam O. Goldstein MD, MPH7, Elyse R. Park PhD, MPH8, Scott E. Sherman MD, MPH9, Michael B. Steinberg MD, MPH10, David A. Albert DDS, MPH11, Lisa Sanderson Cox PhD12, Rashelle B. Hayes PhD13, Sarah D. Hohl PhD, MPH14, Christine E. Sheffer PhD15, Kimberly A. Shoenbill MD, PhD16, Vani N. Simmons PhD17, Graham W. Warren MD, PhD18, Robert Adsit MEd19, Mara Minion MA14, Danielle Pauk BS14, and Betsy Rolland PhD, MLIS, MPH14,20
1 Tobacco Research and Treatment Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; | 2 Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; | 3 Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas; | 4 Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois; | 5 Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York; | 6 Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania; | 7 Department of Family Medicine and Lineberger Comprehensive Cancer Center, UNC School of Medicine, Chapel Hill, North Carolina; | 8 Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; | 9 Department of Population Health, New York University School of Medicine, New York, New York; | 10 Department of Medicine, Rutgers Robert Wood Johnson Medical School; Cancer Institute of New Jersey; and Rutgers Center for Tobacco Studies, New Brunswick, New Jersey; | 11 Department of Dentistry and Public Health, Columbia University Irving Medical Center, New York, New York; | 12 Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas; | 13 Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia; | 14 Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; | 15 Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York; | 16 Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina; | 17 Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida; | 18 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; | 19 Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and | 20 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: C. Kotsen has disclosed serving on an advisory board for the LuCa National Training Network at the University of Louisville. 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.
© 2019-2024 National Comprehensive Cancer Network