Integrating Diversity, Equity, and Inclusion Approaches Into Treatment of Commercial Tobacco Use for Optimal Cancer Care Delivery
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Tobacco-related cancer incidence and mortality and commercial tobacco use have decreased steadily in recent decades, but improvements have not been equitably experienced across population subgroups. A complex interaction across socioecological domains of individual, interpersonal, community/organization, and societal/policy factors influence disparities in tobacco use, treatment, and related health outcomes. NCI’s Cancer Center Cessation Initiative (C3I) provides an ideal platform to examine and intervene on multilevel influences across the cancer control continuum to reduce any disproportionate tobacco-related burden and eliminate tobacco-related disparities. The C3I Diversity, Equity, and Inclusion (DEI) Working Group encourages cancer centers to develop, evaluate, and adopt evidence-based practices regarding DEI for prevention and treatment of commercial tobacco use across the cancer control continuum. This paper highlights how 3 C3I sites intervene to address socioecological influences on tobacco use among racially, ethnically, socioeconomically, and geographically diverse patient subgroups. It then outlines ways in which DEI considerations could be integrated into research with patients with cancer who use tobacco and practices related to standards of cancer care. Incorporating DEI considerations in the pursuit of optimal tobacco treatment could facilitate elimination of inequities in population-level cancer outcomes, spanning the full continuum of cancer care from prevention to survivorship.
The Cancer Center Cessation Initiative Diversity, Equity, and Inclusion Working Group Members
Rashelle B. Hayes PhD1, Jessica L. Burris PhD2, Elisa K. Tong MD, MA3, Niharika Khanna MBBS, MD, DGO4, Ursula Tsosie MS5, Sarah D. Hohl PhD6, Kimlin Ashing PhD7, Gleneara E. Bates-Pappas LMSW8, Lisa Sanderson Cox PhD9, Stephanie Craven Bunch MPH, TTS10, Adam Gaynor MPH, CHES4, Mercy Laurino MS, CGC, PhD5, Katie L. Lenhoff MPH11, Christine E. Sheffer PhD12, Matthew Triplette MD, MPH13, Sophia Yeung MHA, CTTS7, Robert Adsit MEd14, Mara Minion MA6, Danielle Pauk BS6, and Betsy Rolland PhD, MLIS, MPH6,15
1 Department of Psychiatry and Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia; | 2 Department of Psychology and Markey Cancer Center, University of Kentucky, Lexington, Kentucky; | 3 Department of Internal Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, California; | 4 Department of Family Medicine, University of Maryland School of Medicine, Baltimore, Maryland; | 5 Cancer Genetics and Prevention, Seattle Cancer Care Alliance, Seattle, Washington; | 6 Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; | 7 Department of Population Sciences, City of Hope National Medical Center, Duarte, California; | 8 Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, New York, New York; | 9 Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas; | 10 Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina; | 11 Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire; | 12 Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York; | 13 Clinical Research Division, Fred Hutchinson Cancer Research Center; Department of Medicine, University of Washington, Seattle, Washington; | 14 Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and | 15 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 research for the California Tobacco Control Program (Principal Investigator). S.C. Bunch has disclosed receiving research support from Wake Forest School of Medicine. 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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