title: Practice patterns and perceptions of thoracic oncology providers on tobacco use and cessation in cancer patients.
abstract: BACKGROUND
  Tobacco use is associated with poor outcomes in cancer patients, but there is little information from oncology providers on their practice patterns or perceptions regarding tobacco use and smoking cessation in these patients.
  
  
  METHODS
  An online survey of practices, perceptions, and barriers to tobacco assessment and cessation in cancer patients was conducted in members of the International Association for the Study of Lung Cancer (IASLC). Responses of physician-level respondents were analyzed and reported.
  
  
  RESULTS
  Responses from 1507 IASLC members who completed the survey are reported as representing 40.5% of IASLC members. More than 90% of physician respondents believe current smoking affects outcome and that cessation should be a standard part of clinical care. At the initial patient visit, 90% ask patients about tobacco use, 79% ask patients whether they will quit, 81% advise patients to stop tobacco use, but only 40% discuss medication options, 39% actively provide cessation assistance, and fewer yet address tobacco at follow-up. Dominant barriers to physician cessation effort are pessimism regarding their ability to help patients stop using tobacco (58%) and concerns about patient resistance to treatment (67%). Only 33% report themselves to be adequately trained to provide cessation interventions.
  
  
  CONCLUSIONS
  Physicians who care for lung cancer patients recognize the importance of tobacco cessation as a necessary part of clinical care, but many still do not provide assistance to their patients as a routine part of cancer care. Increasing tobacco cessation activities will require increased assessment and cessation at diagnosis and during follow-up, increased clinician education, and improved tobacco cessation methods.
authors.affiliation: Department of Radiation Oncology, Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina 29425, USA. warrengw@musc.edu
authors.forename: Graham W
authors.initials: GW
authors.lastname: Warren
authors.forename: James R
authors.initials: JR
authors.lastname: Marshall
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
authors.forename: Benjamin
authors.initials: B
authors.lastname: Toll
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
authors.forename: Alan
authors.initials: A
authors.lastname: Hutson
authors.forename: Seyedeh
authors.initials: S
authors.lastname: Dibaj
authors.forename: Roy
authors.initials: R
authors.lastname: Herbst
authors.forename: Carolyn
authors.initials: C
authors.lastname: Dresler
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003625:Data Collection; D037001:Directive Counseling; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D010465:Perception; D010818:Practice Patterns, Physicians'; D012907:Smoking; D016540:Smoking Cessation; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices