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. 2025 May;21(5):663-670.
doi: 10.1200/OP.24.00145. Epub 2024 Nov 12.

Specialty Tobacco Treatment Implementation in Oncology: A Qualitative Study

Jennifer E Bird  1 , Jason S Chladek  2   3 , Heather D'Angelo  4   5 , Mara Minion  1 , Danielle Pauk  1 , Robert T Adsit  1   4 , Karen L Conner  1 , Mark Zehner  1 , Michael Fiore  1   4   6 , Betsy Rolland  2   4 , Danielle McCarthy  1   4   6
Affiliations

Specialty Tobacco Treatment Implementation in Oncology: A Qualitative Study

Jennifer E Bird et al. JCO Oncol Pract. 2025 May.

Abstract

Purpose: In 2017, the National Cancer Institute (NCI) funded the Cancer Center Cessation Initiative (C3I) to implement and expand tobacco treatment programs in routine oncology care. Many C3I programs developed specialty care programs staffed by tobacco treatment specialists (TTSs) to deliver evidence-based treatment to adult patients who smoke. People involved in specialty tobacco treatment programs can help to identify implementation strategies and adaptations that may enhance tobacco treatment reach and effectiveness in cancer care and help more patients with cancer quit using tobacco.

Methods: We conducted semistructured interviews with TTSs from 21 C3I-funded cancer centers and applied content analysis to interview transcripts from 37 TTSs and 17 respondents in other program roles. We used the Consolidated Framework for Implementation Research to code interview data. We identified final themes and implementation strategies and adaptations recommended by respondents on the basis of these codes.

Results: Respondents shared that implementation of specialty tobacco treatment programs in cancer care settings could be facilitated by training staff to provide patient connection to services, incorporating prescription of no- or low-cost cessation medications, hiring additional staff to deliver tobacco treatment, allocating space to the program, and automating electronic health record workflows.

Conclusion: TTSs and others involved in specialty tobacco treatment in NCI-designated cancer centers identified ways to improve tobacco treatment access, use, and effectiveness by (1) adapting specialty tobacco treatment delivery to meet patient needs; (2) facilitating referrals and pharmacotherapy coordination; and (3) committing staffing, space, and support resources to tobacco treatment programs. Key program participants suggested that these approaches would help more oncology patients connect with evidence-based tobacco treatment and quit smoking.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/op/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Danielle McCarthy

Employment: University of Wisconsin Health

Uncompensated Relationships: ASCO Just ASK and Beyond ASK Taskforces, National Comprehensive Cancer Network, World Health Organization

No other potential conflicts of interest were reported.

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