Tobacco has long been the leading cause of preventable death in the U.S. because it’s an incredibly difficult habit to break, even in the face of a cancer diagnosis.
Research shows that quitting tobacco use after a cancer diagnosis can lead to improved outcomes — better quality of life, reduced risk of recurrence, fewer treatment complications and longer survival.
Providing these patients with support and evidence-based tobacco treatment is why the National Cancer Institute launched the Cancer Center Cessation Initiative (C3I) in 2017. This initiative, coordinated by UW Health | Carbone Cancer Center and UW Center for Tobacco Research and Intervention, has been transforming the way cancer centers across the U.S. help patients quit tobacco.
“Even after a cancer diagnosis, it is never too late to stop smoking,” said Danielle McCarthy, PhD, a psychologist and principal investigator of the C3I Coordinating Center. “Dr. Michael Fiore, the original leader of the initiative, called for treating tobacco use to be the fourth pillar of cancer care. In addition to surgery, radiation and chemotherapy, tobacco treatment should be considered an essential behavioral intervention for people with cancer who use tobacco.”
Prior to the creation of C3I, many cancer care systems lacked comprehensive tobacco treatment programs. The National Cancer Institute (NCI) selected the pioneering UW Center for Tobacco Research and Intervention, founded in 1992, to coordinate the initiative to build sustainable tobacco treatment programs in NCI-designated comprehensive cancer centers.
“There are probably about 20 million people who actively want to quit using tobacco right now in the United States, and we need to do a better job of supporting them,” McCarthy said. “Cancer care delivery systems do not typically incorporate evidence-based smoking treatment that comprises both medication and a form of counseling. The C3I Coordinating Center gives cancer center the knowledge and practical resources that can help them make treating tobacco use part of the care they provide.”
Since 2017, C3I has worked with 52 NCI-designated comprehensive cancer centers to integrate tobacco treatment into their care, and this has helped connect more than 100,000 tobacco users with evidence-based treatment resources.
Through the Tobacco Treatment Roadmap, C3I also shares tools, case studies and best practices for implementing tobacco treatment across different clinical settings.
“We’ve learned that if you systematically offer tobacco treatment to every patient who uses tobacco, you improve access for all patients, and shrink disparities in access to care,” McCarthy said. “You can have a positive impact by standardizing delivery to everybody.”
Sustainability remains a key focus for the initiative moving forward. The C3I team continues to work with cancer centers to expand access to care and overcome barriers from funding and staffing challenges, to access issues surrounding nicotine replacement therapies.
“The onus of making this change is not on the individual who has had 40 years of addiction,” McCarthy said. “It’s on us as a community, as their care team, and as the health system that supports them. That’s what inspires me–that’s why I love this work.”