Today, the Cancer Quality Council of Ontario (CQCO) released the 2017 Cancer System Quality Index (CSQI), a quality improvement index that highlights where cancer service providers can advance the quality and performance of care. One of the indicators that the interactive web-based public reporting tool highlighted was the commitment to reducing tobacco use among cancer patients by Regional Cancer Care Northwest (RCC-NW), at Thunder Bay Regional Health Sciences Centre.
“Northwestern Ontario continues to have higher smoking rates than the rest of the province, and this has an impact on our cancer system because approximately 30 percent of cancer deaths can be attributed to smoking,” said Dr. Mark Henderson, Executive Vice President of Patient Services and Regional Vice President of Cancer Care Ontario. “Tobacco kills half of its users. Being smoke-free is the best thing that anyone can do to lower their risk of mortality, even for cancer patients.”
In 2014-2015, 25 percent of adults in Northwestern Ontario were daily or occasional smokers, in comparison to the provincial average at 18 percent. Smoking is responsible for approximately 80 percent of lung cancer. The CSQI indicators show that the Northwest has higher incidence rates of lung cancer at 85 new cases per 100,000 people versus the provincial average of 70 cases per 100,00. In addition to lung cancer, many other cancers are associated with tobacco use, including oral, nose, paranasal sinus, esophageal, bladder, kidney, liver, colorectal, pancreatic, cervical, uterine, stomach cancers. Smoking is also a cause of many other chronic illnesses.
Since 2012, Cancer Care Ontario has been working with regional cancer programs to integrate smoking cessation assistance because research shows that the best cancer treatment outcomes can be achieved if patients quit smoking. “The evidence supporting the benefits of quitting smoking before or during cancer treatment is conclusive that smoking cessation services should be integrated in cancer care,” explained Dr. Henderson. “Research shows that cancer patients who quit smoking have more effective treatment, enhance their quality of life, and can also extend the length of their lives. It also helps to prevent other cancers and future chronic illnesses, like heart disease, from occurring once they complete treatment.”
At RCC-NW, new cancer patients are screened for their smoking status, and this screening rate is reported in CSQI. “In the latest CSQI data, it shows that we screened 73 percent of our new patients, which is greater than our target of 70 percent, and higher than the provincial average which is 60 percent,” said Andrea Docherty, Program Director of Regional Cancer Care Northwest. “We are aiming to ask every patient about their smoking status and offer supports for those who want to quit because we know how important quitting smoking can be for our patients.”
Currently, new patients to RCC-NW are screened by a nurse or radiation therapist who asks the patient about their smoking status. If the patient smokes, they are advised on the benefits of quitting smoking, then asked if they would like a referral for help in quitting. If a patient says no, they receive a resource that is specific for smokers who do not want to quit.
If a patient is interested in getting help with quitting, they receive information about quitting and a referral to a nurse practitioner. The nurse practitioner calls the patient and offers them three different smoking cessation options: an appointment with the nurse practitioner to discuss medication and nicotine replacement therapies, a referral to Smokers’ Helpline, and/or counselling with Supportive Care.
“Our goal is to help our patients by providing them with the best treatment we can, and that includes supportive and empathetic smoking cessation. We also hope to educate our patients to ask their care providers for help if they are considering quitting or want to quit smoking,” added Docherty. “It’s never too late to quit smoking, and the information from CSQI encourages us to continue to improve our services so that we can help our patients and families to the best of our ability.”
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