Poster Presentation NSW State Cancer Conference 2023

What do doctors and nurses in cancer centres tell their patients about the benefits of quitting smoking after cancer? (#295)

Christine Paul 1 , Melissa McEnallay 1 , Alison Young 1 , Fiona Day 2 , Shalini Vinod 3 , Emily Stone 3 , Bianca Devitt 4 , Po Yee Yip 5 , Craig Kukard 6 , Abhijit Pal 7 , Tamiem Adam 7 , Alison Hofman 8 , Gavin Wright 9 , Heena Sareen 5 , ShuetOi Wong 7 , Cassandra Rubio 6 , Jennifer Liu 10 , Alexandra Smith 8 , Dimity Betts 1 , Jane Mack 9 , Jennifer Donnelly 9 , Sarah Morris 1 , Elena Stefanovska 1 , Vaibhav Thawal 1
  1. University of Newcastle, Callaghan, NSW, Australia
  2. Calvary Mater Newcastle Hospital, Newcastle, NSW, Australia
  3. University of New South Wales, Sydney, NSW, Australia
  4. Eastern Health, Box Hill
  5. Ingham Institute, Liverpool
  6. Central Coast Cancer Services, Gosford
  7. Bankstown Cancer Centre, Bankstown
  8. Northwest Cancer Centre, Tamworth, NSW
  9. St Vincents Hospital, Melbourne
  10. Monash University, Melbourne

Background:

Continuing cigarette smoking after a cancer diagnosis is associated with reduced survival and increased severity or likelihood of treatment toxicity, complications, hospitalisation, medication side effects and cancer recurrence. Cancer care providers such as oncologists, cancer care coordinators and cancer nurses have a crucial role in communicating the benefits of smoking cessation post-diagnosis. Little is known about what Australian cancer care providers tell their patients about the benefits of cessation at or after diagnosis.

Methods:

During the baseline phase of a stepped-wedge implementation regarding smoking cessation care, staff at nine cancer centres in NSW and Victoria completed online or paper surveys about perceptions and practices regarding smoking cessation care. Staff included doctors (medical oncologists, radiation oncologists, respiratory physicians, surgeons), nurses (cancer care coordinators and cancer nurses) and radiation therapists. The survey listed six known benefits of post-diagnosis smoking cessation (longer survival, improved treatment effects, reduced complications and side effects, faster wound healing, reduced risk of secondary cancer or recurrence, improved quality of life) and asked participants to indicate which of those benefits were generally mentioned when advising their patients to stop smoking.

Results:

A total of 197 doctors, nurses and allied health staff completed the survey. Of the six benefits, 103 participants (52.3%) mentioned reduced complications or side effects to their patients, 98 (49.7%) mentioned improved treatment effects, 85 (43.1%) mentioned reduced risk of secondary cancer or recurrence, 81(41.1%) mentioned longer survival, 80 (40.6%) mentioned improved quality of life, and 64 (32.5%) mentioned faster wound healing. A small proportion (n=11, 5.6%) noted that they mentioned other benefits of stopping smoking. More than one-quarter of the sample (26%) reported that they did not mention any benefits of stopping smoking. Associations between participant characteristics (profession, specialty type, years in profession) and the mention of benefits were also explored.

Conclusion:

Discussions about the benefits of stopping smoking after a cancer diagnosis may tend to focus on treatment-related benefits, which may reflect the nature of some providers’ roles.  It appears that some patients are not being told of any of such benefits. While health care providers are forced to prioritise what they can realistically cover in patient interactions, these data suggest that there are further opportunities for health care providers to counter perceptions that there is nothing to be gained from stopping smoking once a cancer diagnosis has occurred.