School of Women's and Children's Health, UNSW-Sydney, Australia.
Centre for Primary Health Care and Equity, School of Population Health, UNSW-Sydney, Australia; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Australia.
Cancer Epidemiol. 2022 Jun;78:102138. doi: 10.1016/j.canep.2022.102138. Epub 2022 Mar 17.
This paper delineates how a program of tobacco smoking cessation after a cancer diagnosis was achieved by engagement of multiple stakeholders, government, and non-government authorities in one jurisdiction in Australia, New South Wales. While it had become increasingly obvious that smoking cessation imparts benefits akin to other known treatment modalities, knowledge of this generalisation is without benefit unless this information is delivered in a trusted context and means to quit are made available. Against a backdrop of little enthusiasm among clinicians, the Cancer Institute NSW, charged with implementing tobacco control strategies, decided to focus its 2017 annual colloquium on the topic. While the evidence was unequivocal, better clarity was needed that this was indeed a clinical responsibility, and on the resources needed. The Clinical Oncology Society of Australia, (COSA) a non-governmental peak national body representing cancer care professionals, addressed this challenge. The society's governing body resolved to develop a position statement indicating how smoking cessation might be integrated within hospital-based cancer care. The position statement, endorsed by nineteen other cancer and non-cancer organisations, provided reassurance to the Institute to improve record capture of hospital smoking information; upskill all clinical staff and develop an automatic "patient opt out" referral to existing resources such as the Quitline. Early pilot work shows that people newly diagnosed with cancer who smoke and who were advised at that time to quit increased from 55% in 2016 to 72% in 2019.
本文阐述了在澳大利亚新南威尔士州的一个司法管辖区，通过多个利益相关者、政府和非政府机构的参与，如何实现癌症诊断后戒烟计划。虽然越来越明显的是，戒烟带来的好处类似于其他已知的治疗方法，但除非这些信息是在可信赖的背景下传递的，并且提供了戒烟的方法，否则这种普遍认识是没有好处的。在临床医生缺乏热情的背景下，新南威尔士癌症研究所负责实施烟草控制策略，决定将其 2017 年年度研讨会的重点放在这个主题上。虽然证据是明确的，但需要更清楚地认识到这确实是临床责任，以及需要哪些资源。澳大利亚临床肿瘤学会（COSA）是一个代表癌症护理专业人员的非政府国家级机构，该组织应对了这一挑战。该协会的管理机构决定制定一份立场声明，说明如何将戒烟纳入基于医院的癌症护理中。该立场声明得到了其他 19 个癌症和非癌症组织的认可，这为研究所提供了保证，以改善对医院吸烟信息的记录；提高所有临床工作人员的技能，并开发一种自动“患者选择退出”功能，将患者转介到现有的戒烟资源，如 Quitline。早期试点工作表明，新诊断出患有癌症且吸烟的人，以及当时被建议戒烟的人，其比例从 2016 年的 55%增加到了 2019 年的 72%。
