Smoking Cessation Practices in Australian Oncology Settings: A Cross-Sectional Study of Who, How, and When

Purpose: Patients who smoke tobacco during and after a cancer diagnosis have poorer health outcomes. Oncology healthcare providers (HCPs) are crucial to providing smoking cessation support. The study examined the characteristics associated with differences in HCPs' smoking cessation practices. Methods: As part of the Care to Quit trial, a cross-sectional survey exploring smoking cessation practices was completed by HCPs across nine cancer centers in New South Wales and Victoria, Australia. Results: One hundred and seventy-seven HCPs completed the survey. Over half of the HCP respondents reported asking patients their smoking status, but fewer than half advised patients about the benefits of quitting, referred patients to behavioral support such as Quitline, or offered pharmacotherapy medication. All components of the "3A's" model (Ask, Advise, Act) were more likely to be completed by doctors compared to registered nurses (OR: 7.86, 95% CI: 3.64, 16.95, p<0.001), by those with more years of practice (OR: 0.26, 95% CI: 0.07-0.93, p = 0.039), and those who had received smoking cessation training (OR: 3.91, 95% CI: 1.80, 8.48, p = 0.001). Multivariate analyses also identified differences in the amount of cancer-specific advice provided between occupation type (p<0.001) and years of practice (p = 0.021). Conclusion: The need for smoking cessation care training in oncology continues to be apparent. Training in prescribing pharmacotherapies (for doctors) or supporting the use of pharmacotherapies (for nurses) is a particular "gap." Differences between the roles and engagement of doctors and nurses in relation to smoking cessation care should be carefully considered when developing site-specific models of cessation care and providing training.