Exploring gender differences in receipt of the 5As for smoking cessation for recently diagnosed cancer patients (ECOG-ACRIN EAQ171CD)

Lucy Finkelstein-Fox, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
JoRean D. Sicks, Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA.
Lynne I. Wagner, Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
Ruth C. Carlos, Department of Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Isabelle L. Miranda, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Rachel L. Rosen, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Maria Lopes, Department of Psychology, University of Miami, Coral Gables, FL, USA.
Brett M. Goshe, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Ilana F. Gareen, Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA.
Benjamin A. Herman, Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA.
Alexander Taurone, Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA.
Angela Wangari Walter, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA.
Autumn W. Rasmussen, Department of Clinical Psychology, William James College, Newton, MA, USA.
Douglas E. Levy, Mongan Institute, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Michael A. Thompson, Advocate Health - MidwestFollow
Laura Malloy, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Irina Gonzalez, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Brian L. Burnette, Cancer Research of Wisconsin and Northern Michigan (CROWN) - NCORP, Saint Vincent Hospital Cancer Center, Green Bay, WI, USA.
Alyssa D. Throckmorton, Multidisciplinary Breast Program, Baptist Cancer Center, Memphis, TN, USA.
Martha S. Tingen, Department of Medicine, Augusta University Medical College of Georgia, Augusta, GA, USA.
Jamie S. Ostroff, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Elyse R. Park, Health Promotion and Resiliency Intervention Research Center (HPRIR), Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.

Abstract

Introduction: Smoking cessation is important for men and women diagnosed with cancer. Oncology clinicians should encourage all patients to quit and offer resources to help them do so, following the 5As framework (Ask, Advise, Assess, Assist, and Arrange follow-up).

Aims and methods: This study tests gender differences in self-reported receipt of the 5As from an oncology provider among 306 recently diagnosed male and female cancer patients. Receipt of praise for quitting efforts was also assessed as an indicator of empathic communication. Participants completed baseline surveys as part of a larger clinical trial focused on smoking cessation (NCT03808818), reflecting on pretrial interactions with their oncology clinicians.

Results: Most male and female patients received "Ask," "Advise," and "Assess" (ie, asking patients if they smoke, advising them to quit, and assessing their interest in doing so), though significant gender differences emerged in receiving "Assist" and "Arrange follow-up." Women were less likely to receive assistance (eg, medication or counseling referral; 85.25% vs. 93.18%, respectively) or a follow-up appointment to discuss their progress (28.11% vs. 40.91%, respectively). Approximately half of men and women were praised for their quitting efforts. In exploratory sensitivity analyses, gender differences in "Arrange follow-up" were attenuated when adjusting for cancer location (smoking-related or not), self-reported distress, and self-reported coping ability.

Conclusions: Women may be at risk for suboptimal smoking-related support during cancer care, as assistance and follow-up are essential to sustained abstinence. Clinicians should consistently deliver each of the 5As to all cancer patients who smoke, regardless of cancer type or expressed distress/coping difficulty.

Implications: The current study findings add to the growing literature describing gender disparities in tobacco treatment access. Findings highlight an addressable gap in access to tobacco treatment for a group of women who have cancer. Advancements in the equitable delivery of smoking cessation counseling have the potential to improve cessation outcomes for women with cancer who smoke.

Document Type

Article

PubMed ID

39697094

Link to Full Text

 

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