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A new University of Kentucky Markey Cancer Center study highlights the success of the largest-ever quality improvement initiative to focus on the critically important issue of smoking among cancer patients. The study, led by UK Markey Cancer Center researcher Jessica Burris, Ph.D.
, and published in the Journal of Clinical Oncology Nov. 19, analyzed outcomes from the American College of Surgeons' (ACS) "Just Ask" quality improvement program . The initiative, led by Timothy Mullett, M.
D., Markey Cancer Center surgeon and former chair of the ACS Commission on Cancer, was implemented at 762 cancer care facilities nationwide—making it the largest effort of its kind to improve smoking assessment and documentation in cancer care settings. The study found that programs participating in Just ASK improved their rates of assessing and documenting patients' smoking status, with the assessment rate increasing to nearly 92% by the end of the one-year program.
Smoking among patients diagnosed with cancer is associated with treatment-related complications plus cancer recurrence, poor survival and increased treatment costs. Despite these risk factors , nearly 25% of new patients with cancer and 16% of cancer survivors report current smoking. Smoking assessment, or "just asking" is an important first step in helping patients with cancer access evidence-based smoking cessation treatment, which can improve their cancer treatment outcomes, says Burris, co-leader of Markey's Cancer Prevention and Control Research Program and an associate professor in the UK College of Arts and Sciences' Department of Psychology.
"What this study shows is that we can successfully make population-based smoking assessment a standard part of cancer care," said Burris. "This is important because before providers can help patients quit smoking—which we know improves their health outcomes and reduces treatment costs—they first need to identify who needs that support. Providers being proactive in asking about smoking and offering support is key since stigma and guilt will stop some patients from asking for the help they need to quit successfully.
" Just ASK was adopted by a wide range of oncology settings, including academic facilities and both large and small community cancer programs. Participating programs gained access to an online toolkit that contained information about evidence-based smoking assessment and cessation assistance practices, technical tools, and training and education opportunities. Programs implemented several practical recommendations to improve smoking assessment for patients with cancer, including training staff and providers, developing patient education materials, and improving smoking-related documentation.
A second ACS quality improvement project called Beyond Ask addresses building programs' capacity to offer cessation assistance. More information: Jessica L. Burris et al, Longitudinal Results From the Nationwide Just ASK Initiative to Promote Routine Smoking Assessment in American College of Surgeons–Accredited Cancer Programs, Journal of Clinical Oncology (2024).
DOI: 10.1200/JCO.24.
00304.
