Cancer Moonshot Part II: No Smoker Left Behind

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Quitting smoking is difficult. Tobacco is highly addictive. Quitting may require multiple attempts. Some people break the tobacco habit on their own, but most do better with help.

Those who turn to comprehensive smoking cessation services, including counseling and medications to lessen withdrawal symptoms, can double or triple their chances of quitting.

It can be difficult, however, for cancer patients to connect with these programs. A 2018 survey found that less than half of cancer centers nationwide offer comprehensive tobacco cessation services. The National Cancer Institute (NCI) and its Cancer Moonshot initiative have dedicated resources to help selected cancer centers develop comprehensive smoking cessation programs.

The goal is to fund programs that serve as “an example of how cancer patients who use tobacco should be treated,” said Glen Morgan, PhD, program director of NCI’s Tobacco Control Research Branch. Of the 62 NCI-designated cancer centers, only 22 — including the UChicago Medicine Comprehensive Cancer Center — were selected to lead this initiative in its first year.

The UChicago Medicine Comprehensive Cancer Center chose an ambitious goal: No Smoker Left Behind. There is no cost to enroll in this program. It is supported by a $500,000 supplemental award from the NCI.

No Smoker Left Behind is designed specifically to help cancer patients stop smoking. The program intends to treat 1,000 patients in the first year, primarily those with lung or head and neck cancers. In the second year, the program aims to treat up to 2,500 patients across all cancer types.

“Our goal is to identify cancer patients who smoke and offer smoking cessation treatment and follow-up throughout the cancer care process,” said Andrea King, PhD, professor of psychiatry at the University of Chicago Medicine and co-director of the program.

There are good reasons for anyone, especially cancer patients and survivors, to stop smoking. According to SmokeFree.gov, quitting cigarettes can add years to your life, reverse some of the scarring of your lungs, reduce the risk of emphysema, improve blood flow, protect your heart, lower cholesterol, strengthen muscles, fortify bones, enhance the immune system, sweeten breath and boost sexual performance. For cancer patients, quitting smoking can improve the effects of treatment and help prevent a recurrence.

Starting in January 2019, cancer patients who smoke will be automatically enrolled in No Smoker Left Behind. The program, which offers a menu of evidence-based treatment options, follows patients for six months. It tracks progress and connects patients to services as needed.

The menu of treatment options includes on-site individual or group counseling and telephone-based support. Cancer patients can select what best fits their needs (or they can choose to opt out of the program).

Individual counseling with the program’s dedicated tobacco treatment specialist provides strategies to help each patient quit smoking. The program also supplies patients who are interested with starter kits for nicotine replacement therapy.

“Nicotine replacement and other approved therapies can double or triple the odds of being successful at quitting smoking,” King said. “We encourage patients to consider these options.”

Patients can schedule individual appointments with the tobacco treatment specialist on-site at UChicago Medicine. These can be scheduled to coincide with their cancer treatment visits. No Smoker Left Behind will provide individual counseling three times per week.

Group counseling also is offered through the Courage to Quit® program, a group-based, comprehensive approach to smoking cessation developed and led by King and her team of trained counselors.

Cancer incidence rates on the South Side of Chicago are higher than the national average. Yasmin Asvat, PhD, assistant professor of psychiatry, program co-director and author of a previous study of Courage to Quit®, stressed the importance of addressing racial disparities in smoking rates.

Currently, 80 percent of patients who participate in Courage to Quit® are African American. The program had a 36 percent quit rate after only one month. African Americans and whites had similar completion and quit rates.

No Smoker Left Behind can also connect patients with treatment options via telephone, through the Illinois Tobacco Quitline, or the text-messaging program, SmokeFreeTXT, managed by the National Cancer Institute.

“Many of our cancer patients travel long distances for cancer care,” Asvat said. “Where you live is not a barrier for access to smoking cessation support.”

“Quitting smoking is the most important lifestyle change patients can make to fight cancer and have the best possible treatment results,” said Jyoti Patel, MD, a UChicago Medicine lung cancer specialist. The benefits of quitting smoking after cancer diagnosis include “faster recovery, fewer serious side effects and reduced risk of being diagnosed with a second cancer,” she said.

For more information, call 773-702-6188 or email NoSmoker@uchospitals.edu.