The 2014 Surgeon General’s report underscored the importance of helping patients with cancer quit smoking, because continued smoking after a diagnosis is causally linked to cancer-specific and all-cause mortality.1 More than 50% of patients with cancer who smoked before diagnosis continue to smoke after diagnosis and treatment,2 leading to calls from NCCN,3 ASCO,4 and the American Association for Cancer Research5 to implement tobacco cessation treatment within oncology care. Despite being uniquely positioned to intervene, only half of NCI-designated Cancer Centers systematically identify tobacco use among patients,6 and few centers and oncology practices consistently provide smoking cessation services.5 To enhance patient outcomes, improved systems are needed to consistently identify patients who smoke and to ensure that they more effectively engage in evidence-based treatments.
In recognition of these issues, NCI developed the Cancer Center Cessation Initiative (C3I) in 2017, with support from the Cancer Moonshot initiative (https://cancercontrol.cancer.gov/brp/tcrb/cessation-initiative.html), to build and sustain an infrastructure across the nation’s cancer centers to ensure patients with cancer are systematically screened for tobacco use and provided evidence-based smoking cessation treatment.7 This program supported 22 cancer centers around the United States initially, and an additional 20 were funded in the fall of 2018, with biannual meetings for grant recipients, scientific and technical support from a coordinating center at the University of Wisconsin, and collaborative efforts focused on sustained institutional cancer center commitment to reduce patient tobacco use. This commentary describes the progress made at Abramson Cancer Center at the University of Pennsylvania to build a sustainable and implementation-science–informed infrastructure to address patient tobacco use, including initial program effects on clinical treatment and future directions that might inform other efforts.
The authors wish to thank Dr. Michael Fiore and his staff at the University of Wisconsin for serving as the coordinating center for the C3I; Dr. Glen Morgan for reviewing a draft of this manuscript; Drs. Rebecca Ashare, Lynn Schuchter, Lawrence Shulman, and James Metz for helping to support the TUTS program; and Ms. Tierney Fischer and Ms. Jody Nicoloso for operating TUTS.
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)| false . , Nekhlyudov L , Lacchetti C , Davis NB Head and neck cancer survivorship care guideline: American Society of Clinical Oncology clinical practice guideline endorsement of the American Cancer Society guideline. 2017; 35: 1606– 1621. 10.1200/JCO.2016.71.8478
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)| false . , Toll BA , Brandon TH , Gritz ER AACR Subcommittee on Tobacco and Cancer. Assessing tobacco use by cancer patients and facilitating cessation: an American Association for Cancer Research policy statement. 2013; 19: 1941– 1948. 10.1158/1078-0432.CCR-13-0666
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