*Department of Radiation Oncology, †Department of Cell and Molecular Pharmacology, Medical University of South Carolina (MUSC), Charleston, South Carolina; ‡Department of Biostatistics and Bioinformatics, RPCI, Buffalo, New York; §Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, South Carolina; ‖International Association for the Study of Lung Cancer, and ¶Division of Cancer Prevention and Population Science, RPCI, Buffalo, New York.
J Thorac Oncol. 2015 Nov;10(11):1532-7. doi: 10.1097/JTO.0000000000000659.
Although smoking causes adverse outcomes in cancer patients, most oncology providers do not regularly provide smoking cessation support. The purpose of this study was to identify key areas that can be targeted to improve delivery of evidence-based cessation support for cancer patients.
In 2012, the International Association for the Study of Lung Cancer surveyed members asking about tobacco assessment and cessation practices for cancer patients. Responses from 1153 physician level oncology providers were analyzed to evaluate the effects of respondent demographics, tobacco use perceptions, and perceived barriers to providing cessation support on practice patterns.
Respondents from the United States generally reported higher rates of asking about tobacco use, advising patients to quit, and assisting patients in quitting smoking. Work setting, time since completing a terminal degree, percent of time devoted to clinical care, and history of tobacco use were generally associated with asking about tobacco use and advising patients to quit, but not associated with discussing medications or actively treating patients. The dominant multivariate barriers to providing cessation support were a lack of clinician education or experience and lack of available resources to refer patients for smoking cessation support. Patient resistance to treatment, inability for patients to quit smoking, or feeling that smoking was not an important part of cancer outcome or cancer care had less meaningful associations with providing support.
Improving clinician education and developing dedicated resources to provide cessation support were identified as ideal targets to address for improving cessation support for cancer patients.
尽管吸烟会对癌症患者造成不良后果，但大多数肿瘤学医生并没有定期提供戒烟支持。本研究的目的是确定可以针对哪些关键领域进行改进，以提高为癌症患者提供基于证据的戒烟支持。
2012 年，国际肺癌研究协会对其成员进行了调查，询问他们对癌症患者的烟草评估和戒烟情况。分析了来自 1153 名肿瘤学医生的回复，以评估受访者的人口统计学特征、对烟草使用的看法以及提供戒烟支持的障碍感知对实践模式的影响。
来自美国的受访者通常报告了更高的烟草使用询问率、建议患者戒烟率和帮助患者戒烟率。工作地点、完成研究生学位的时间、临床护理时间百分比和吸烟史与询问烟草使用和建议患者戒烟有关，但与讨论药物或积极治疗患者无关。提供戒烟支持的主要多元障碍是缺乏临床医生的教育或经验，以及缺乏可用于转介患者接受戒烟支持的资源。患者对治疗的抵触、患者无法戒烟、或认为吸烟不是癌症结果或癌症护理的重要组成部分，与提供支持的关联意义较小。
提高临床医生的教育水平和开发专门的资源来提供戒烟支持被确定为改善癌症患者戒烟支持的理想目标。
