The nationwide Cancer Center Cessation Initiative (C3I), part of the NCI Cancer Moonshot Initiative, held a grantee meeting at the Pyle Center in Madison, Wisconsin. Representatives from 42 NCI cancer centers (the grantees) attended, along with other tobacco cessation leaders.
The two-day event, hosted by UW Carbone Cancer Center (UW-CCC) coordinating center, included updates on grantee progress toward helping cancer patients to quit smoking.
“While about 30 percent of all cancer deaths are directly caused by smoking,” said UW-CTRI Director Dr. Michael Fiore, “not all oncology departments are addressing it with every patient who smokes.”
The first cohort of 22 cancer centers have already started to change that in their first year. At the Pyle Center, cohort 1 grantees reported:
- Higher system-wide assessment of tobacco use.
- Champion clinicians and surgeons who demand patients quit smoking before providing treatment.
- The use of smart sets to streamline care.
- Quality-improvement assessments.
- Patients receiving state-of-the-science treatments to help them quit tobacco use. Some have quit and are glad to be tobacco-free.
As with any major undertaking, there have been barriers to overcome. Some cohort 1 grantees reported challenges, such as:
- Limited referrals from oncologists.
- Staff changes or shortages.
- Results varying from clinic to clinic, even within the same system, in part due to different patient demographics and clinic buy-in.
- Integrating tobacco treatment protocols into EHR.
EHR integration was the most common challenge, and C3I has already taken steps to help grantees with that.
“We are really happy to report that NCI has provided new funding to offer technical support around information technology for each grantee,” said Rob Adsit (left), UW-CTRI Outreach Director and a national expert on tobacco treatment integration into EHR. Adsit has also served on the Wisconsin Cancer Council. “Every grantee is doing something with their electronic health records. We needed more support on very technical issues. We have contracted with an EHR consulting group called the HCI company.
Importantly, they are EHR-agnostic. While 60 percent of grantees use an EPIC EHR, there are also other EHRs being used.”
Fiore encouraged grantees to be proactive. “It’s critically important to identify clinical champions, as well as health system leadership and IT champions, to work with you every step of the way to implement your grants.”
Dr. Glen Morgan, a clinical psychologist at the NCI’s Tobacco Control Research Branch and the funding contact for C3I, said he was happy to hear about cohort 1 progress, and encouraged the 20 grantees in cohort 2 to follow suit.
“Vertical takeoff, then accelerate,” Morgan said.
Some grantees have a more uphill battle than others. Smoking rates range from about 5 percent to 23 percent at various clinical grantee sites. This may influence the tailored treatments implemented, Fiore said. “It will give us a sense of how different centers with different prevalence can reach their smokers.”
UW-CCC Director Dr. Howard Bailey said he was encouraged by the grantees’ work, and the promise of the project. “We can work together to prevent tobacco use,” he said, “and improve the health of society, our nation and the globe.”
Making it Possible
The entire University of Wisconsin C3I team worked on getting the meeting organized—including UW-CCC Assistant Director and Principal Investigator of the C3I Coordinating Center Betsy Rolland, UW-CCC Coordinating Center Manager Danielle Pauk, UW-CTRI Associate Research Specialist Marika Rosenblum, and UW-CCC Assistant Scientist Heather D’Angelo, along with Fiore and Adsit.
“We also had help from Katrina Bundy at UW-CTRI getting the logistics in place before I started,” said Pauk, “and help from Jennifer Leidenberger at ICF (an event consulting firm). On the day of, UW-CTRI colleagues Kami Brey, Alex Peeters, and Amy Skora were a huge help!”
In part, the Moonshot was inspired by Beau Biden, who died of brain cancer in 2015 and is the son of former Vice President Joe Biden.