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Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hispanic patients with cancer who smoke are less likely to quit after diagnosis and underutilize evidence-based tobacco treatment. Understanding the complex factors influencing their engagement is crucial for developing effective and tailored interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi-structured individual interviews were conducted with 12 adult patients with cancer who self-identified as Hispanic or Latino referred between June 1, 2023, and June 30, 2024, to a tobacco treatment program embedded within a cancer center. Interviews were conducted via phone or video in English or Spanish. Transcripts were thematically analyzed, guided by the Socio-ecological Model, assessing individual, interpersonal, organizational, community, and policy barriers and facilitators affecting treatment engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age was 65 and most participants (10) were women. Four multilevel themes emerged from the data: (1) Socio-Cultural Drivers and the Psychological Barrier of Fatalism; (2) Provider\u2013Patient Relationship Enhances Engagement; (3) Community and Cultural Contexts Shaping Tobacco Use and Support Needs; and (4) Structural, Economic, And Policy-Level Determinants Constrain Access; Implementation and Enforcement are Key Levers. Additionally, the decision to accept or decline treatment further distinguished by differences in age\/fatalism, provider relationship\/trust, and the view of willpower versus external support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Engagement in tobacco treatment among Hispanic patients with cancer is shaped by the intersection of individual, cultural, and structural barriers and facilitators. Findings highlight the need for culturally and linguistically congruent interventions that address fatalism, integrate family support, reduce financial barriers, and leverage the patient-provider relationship to improve access and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-026-02915-1","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:50:33Z","timestamp":1775490633000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative Analysis of Barriers and Facilitators to Tobacco Treatment Engagement Among Hispanic Patients with Cancer in New York City"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6270-0326","authenticated-orcid":false,"given":"Ruthmarie","family":"Hern\u00e1ndez-Torres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Gilliland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianel","family":"Rosario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gleneara","family":"Bates-Pappas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lou-Anne","family":"Chichester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Costas-Mu\u00f1\u00edz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Kotsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie S.","family":"Ostroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"issue":"3","key":"2915_CR1","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1093\/jnci\/djab208","volume":"114","author":"AM Leventhal","year":"2022","unstructured":"Leventhal AM, Dai H, Higgins ST. 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This classification is appropriate for local QI initiatives focused on improving existing processes.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"To ensure ethical conduct, all participants were informed about the project and provided verbal consent prior to participation, agreeing to the use of a recording device. Confidentiality and privacy were maintained throughout the project by assigning each participant a sequential identifier (Pt. 1 to Pt. 12). Participants retained full autonomy and the ability to withdraw from the project or request clarification at any time.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"The authors declare no conflicts of interest. The funding sponsors had no role in the study\u2019s design, in the collection, analysis, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest\/Competing Interests"}}]}}