October 13, 2020
Programs designed to help cancer patients stop using tobacco should be considered as important and impactful as providing聽the right drug at the right time and at the right dose to patients, according to researchers at 黑料网 Lineberger Comprehensive Cancer Center.
In an editorial published in JAMA, 黑料网 Lineberger鈥檚 , director of the 黑料网 Tobacco Treatment Programs and professor in the 黑料网 Department of Family Medicine, and his co-authors .
Research has shown that providing intensive smoking cessation counseling to newly diagnosed cancer patients who smoke was associated with improved quality of life, fewer complications related to cancer treatments and longer survival. In addition, a study published last year found some cancer treatments were less effective in people who smoke, and this resulted in significantly greater costs for subsequent cancer treatments.
鈥淪ince cancer patients often get expensive chemotherapy for months to years to help cure their cancer, six months of inexpensive intensive tobacco聽cessation support at the time of diagnosis is scientifically proven, common sense and improves all outcomes of cancer care,鈥� said Goldstein.
Kimberly Shoenbill, MD, PhD, assistant professor of Family Medicine and a member of the Program on Health and Clinical Informatics at 黑料网, and , assistant professor of medicine and 黑料网 Lineberger member, are the editorial鈥檚 two other authors.
Their editorial accompanied a study by Elyse Park, PhD, and colleagues that compared the impact of an intensive versus standard cancer center smoking cessation intervention, with different levels of intensity and frequency of counseling, support and medications. The study showed patients who completed the study and were part of the intensive treatment group 鈥� which had weekly, biweekly and monthly telephone counseling sessions and free cessation medication 鈥� achieved higher seven-day abstinence rates at six-month follow-up (34.5%) compared to patients in the standard treatment group (21.5%).
Goldstein said the study demonstrates for the first time the value and necessity of providing intensive smoking cessation counseling, of up to eight sessions per quit attempt, as a standard for cancer care. These findings, he said, should serve as a wake-up call for hospitals, cancer centers, physicians and payers.
鈥淓xcellence in cancer care is defined by a great team, delivering great care, with everyone focused on the patient and their family.聽A great cessation program in cancer centers requires unequivocal buy-in at all levels,鈥� Goldstein said.聽鈥淵ou cannot have a great cancer hospital today without a great cessation program for cancer patients.鈥�
There are a number of challenges that cancer centers may experience in implementing intensive smoking cessation programs. This includes a reluctance by oncologists to provide the intensive counseling 鈥� which may be due, in part, to time constraints and lack of smoking cessation training 鈥� and insufficient reimbursement for counseling services.
鈥淢edicare, Medicaid and most private insurers usually pay less than $100 for only four total counseling sessions per quit attempt, yet they will readily pay over $100,000 a year for drugs to treat cancer. Current fee-for-service reimbursement does not begin to cover the cost of providing intensive cessation counseling,鈥� Goldstein said. This reimbursement model is shortsighted, he noted, because the expense of providing intensive smoking cessation counseling results in immediate cost savings and improved health in the long run.
鈥淔or every $1 invested in a cancer center cessation program, $6 in savings from reduced future costs likely occurs, making intensive cessation counseling perhaps the most cost-effective, cheapest and safest cancer treatment currently possible,鈥� Goldstein said.
鈥淗ealth care systems are rapidly changing to value-based care. As payers increasingly track outcomes of care, when they compare patients treated in health care systems that offer intensive cessation counseling that result in patients quitting smoking, compared to systems where they receive neither, the choice is obvious.鈥�
About the 黑料网 Lineberger Comprehensive Cancer Center
The 黑料网 Lineberger Comprehensive Cancer Center is a cancer research and treatment center at the University of North Carolina at Chapel Hill. Serving patients at the N.C. Cancer Hospital, 黑料网 Lineberger is the only public comprehensive cancer center in the state of North Carolina. One of the leading cancer centers in the nation, 黑料网 Lineberger Comprehensive Cancer Center is located in Chapel Hill, North Carolina. As one of only 51 , 黑料网 Lineberger was rated as exceptional 鈥� the highest category 鈥� by the National Cancer Institute. The center brings together some of the most exceptional physicians and scientists in the country to investigate and improve the prevention, early detection and treatment of cancer.