Patient navigation-based tobacco harm reduction program among cancer patients

Introduction Continued smoking after cancer diagnosis has been associated with increased risks of all-cause and cancer-specific mortality, disease progression, tobacco-related second primary cancer, cancer recurrence, poor treatment response, and treatment-related toxic effects. Tobacco cessation has substantial benefits in the oncology population and presents as a highly feasible and cost-effective strategy to improve cancer treatment outcomes. However, because of limited time, training or resources, the percentage of oncologists who provided tobacco treatment support to cancer patients has been relatively low. In cancer care, patient navigation has shown positive effects on increasing uptake of screening, treatment adherence and quality of life. By providing individualized assistance and addressing barriers, patient navigator represents a promising bridge between the cancer patients who smoke cigarettes and the existing tobacco treatment resources. Methods A single-arm observational cohort study design was used to test the feasibility and preliminary efficacy of patient navigation-based intervention to promote connection to tobacco treatment in current cigarette smokers with cancer. All the participants received smoking cessation educational brochure and patient navigation sessions (by phone) delivered over two months. Participants were recruited from the Penn State Cancer Institute (PSCI) outpatient clinics. The primary outcome was feasibility of the patient navigation-based intervention. The assessment of feasibility included a process evaluation of recruitment. We also studied the preliminary efficacy by measuring engagement in tobacco treatments at two-month follow up. Engagement in treatment was defined as completion of at least one tobacco cessation counseling session OR use of at least one FDA-approved smoking cessation medication for at least 1 day. Results A total of 1168 unique patients were screened for this study, 984 (84.2%) had tobacco use status available in medical records, and 134 (11.5%) patients were identified as current cigarette smokers. Among 67 potentially eligible patients who were approached at outpatient clinics, 24 (35.8%) were interested in participating, and 12 (17.9%) were enrolled. A final of 8 participants completed two intervention sessions and final assessment, and 75% engaged in tobacco treatment. In addition to smoking cessation, patient navigation seems to promote stage of change regarding smoking cessation to contemplation or preparation (70% vs. 100%), and reduce cigarettes smoked per day (median: 11.0 vs. 6.5). Overall, participants were satisfied with intervention sessions and thought it is helpful. Conclusion The patient navigation-based intervention is feasible and effective in cancer patients to promote connection to tobacco treatments. Our results provide the basis for future larger-scale investigations on maximizing the effectiveness of the navigation-based cessation intervention in cancer patients and incorporating the intervention into health care system.



Work Title Patient navigation-based tobacco harm reduction program among cancer patients
Open Access
  1. Tongyao Fan
License In Copyright (Rights Reserved)
Work Type Dissertation
  1. Committee members, Penn State Cancer Institute lung cancer and head & neck cancer disease teams
Publication Date 2021
Deposited December 03, 2021




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Work History

Version 1

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  • Updated Acknowledgments Show Changes
    • Committee members, Penn State Cancer Institute lung cancer and head & neck cancer disease teams
  • Added Creator Tongyao Fan
  • Added Final IDR_Tongyao Fan.pdf
  • Updated License Show Changes
  • Published
  • Updated Work Title Show Changes
    Work Title
    • Patient navigation-based tobacco harm reduction program among cancer patients
  • Updated

Version 2

  • Created
  • Deleted Final IDR_Tongyao Fan.pdf
  • Added Final IDR_Tongyao Fan_03_30_2022.pdf
  • Updated Keyword Show Changes
    • cancer research, tobacco related cancer, smoking after cancer
  • Published