A Comparison of Australian Oncology Clinicians' Smoking Cessation Care Practices for People Who Currently Smoke Versus Those Who Report Recently Stopping Smoking

Abstract

Smoking is a chronic relapsing condition that is under-reported in oncology settings. People who report current smoking (CS) and those who report recently quitting smoking (RQ) should receive cessation support when they are diagnosed with cancer. The study aimed to identify whether differences exist in the smoking cessation support given to CS and RQ in oncology and what advice is given regarding the benefits of cessation. A survey exploring smoking cessation practices was completed by oncology clinicians (medical, nursing, and allied health) at nine cancer centers in Australia. Data were analyzed using mixed-effects ordinal regression modeling. Across the 177 clinicians completing the survey, the reported provision of smoking cessation care was significantly higher for CS than for RQ in relation to asking about smoking status (odds ratio [OR] 3.03, p = 0.001), advice on the benefits of quitting (OR 2.86, p = 0.001), and advice to call the Quitline (OR 5.08, p < 0.001). Exploratory analyses indicated doctors and nurse specialists were four times more likely to report referring CS to a Quitline compared to RQ (OR 4.38, p = 0.001; OR 4.29, 95%, p = 0.005, respectively). The cessation benefits that clinicians most often cited to their patients was that quitting "can reduce the chance of developing treatment complications and side effects". The relative lack of smoking cessation care provided to RQ in oncology suggests that the high risk of smoking relapse is not well-recognized. Greater awareness and training are needed regarding advising RQ about the survival-specific benefits of continuing to not smoke, offering referrals, and offering follow-up support.