{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:58:31Z","timestamp":1793347111348,"version":"4.5.0"},"reference-count":14,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Smoking cessation after a cancer diagnosis can significantly improve a person\u2019s prognosis, treatment efficacy and safety, and quality of life. In 2012, Cancer Care Ontario (now part of Ontario Health) introduced a Framework for Smoking Cessation, to be implemented for new ambulatory cancer patients at the province\u2019s 14 Regional Cancer Centres (RCCs). Over time, the program has evolved to become more efficient, use data for robust performance management, and broaden its focus to include new patient populations and additional data collection. In 2017, the framework was revised from a 5As to a 3As brief intervention model, along with an opt-out approach to referrals. The revised model was based on emerging evidence, feedback from stakeholders, and an interim program evaluation. Results showed an initial increase in referrals to cessation services. Two indicators (tobacco use screening and acceptance of a referral) are routinely monitored as part of Ontario Health\u2019s system-wide performance management approach, which has been identified as a key driver of change among RCCs. Due to the COVID-19 pandemic, many RCCs reported a decrease in these indicators. RCCs that were able to maintain a high level of smoking cessation activities during the pandemic offer valuable lessons, including the opportunity to swiftly leverage virtual care. Future directions for the program include capturing data on cessation outcomes and expanding the intervention to new populations. A focus on system recovery from COVID-19 will be paramount. Smoking cessation must remain a core element of high-quality cancer care, so that patients achieve the best possible health benefits from their treatments.<\/jats:p>","DOI":"10.3390\/curroncol29070365","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T20:53:02Z","timestamp":1656622382000},"page":"4604-4611","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evolution of a Systematic Approach to Smoking Cessation in Ontario\u2019s Regional Cancer Centres"],"prefix":"10.3390","volume":"29","author":[{"given":"Erin","family":"Cameron","sequence":"first","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Lee","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sargam","family":"Rana","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Haque","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahara","family":"Khan","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Truscott","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Rabeneck","sequence":"additional","affiliation":[{"name":"Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"ref_1","unstructured":"U.S. Department of Health and Human Services (2014). The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1158\/1078-0432.CCR-13-0666","article-title":"Assessing tobacco use by cancer patients and facilitating cessation: An American Association for Cancer Research policy statement","volume":"19","author":"Toll","year":"2013","journal-title":"Clin. Cancer Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e185","DOI":"10.3747\/co.23.3506","article-title":"Lessons learned implementing a province-wide smoking cessation initiative in Ontario\u2019s cancer centres","volume":"24","author":"Evans","year":"2017","journal-title":"Curr. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.amepre.2008.04.009","article-title":"A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service Report","volume":"35","author":"Fiore","year":"2008","journal-title":"Am. J. Prev. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1200\/JOP.2010.000175","article-title":"National Cancer Institute conference on treating tobacco dependence at cancer centres","volume":"7","author":"Morgan","year":"2011","journal-title":"J. Oncol. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/add.12793","article-title":"Implementation of a new \u2018opt-out\u2019 default for tobacco treatment is urgently needed, but requires free access to evidence-based treatments","volume":"110","author":"Kotz","year":"2015","journal-title":"Addiction"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/add.12734","article-title":"It\u2019s time to change the default for tobacco treatment","volume":"110","author":"Richter","year":"2015","journal-title":"Addiction"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"471","DOI":"10.3390\/curroncol28010049","article-title":"Identifying best implementation practices for smoking cessation in complex cancer settings","volume":"28","author":"Giannopoulos","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"226","DOI":"10.3747\/co.25.3921","article-title":"How can we better help cancer patients quit smoking? The London Regional Cancer Program experience with smoking cessation","volume":"25","author":"Davidson","year":"2018","journal-title":"Curr. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3747\/co.27.5267","article-title":"Does free nicotine replacement improve smoking cessation rates in cancer patients?","volume":"27","author":"Arifin","year":"2020","journal-title":"Curr. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.3390\/curroncol29030130","article-title":"Rates of smoking cessation at 6 and 12 months after a clinical tobacco smoking cessation intervention in head and neck cancer patients in Northern Ontario, Canada","volume":"29","author":"Santi","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"53","DOI":"10.12927\/hcq.2020.26138","article-title":"From measurement to improvement in Ontario\u2019s cancer system: Analyzing the performance of 28 provincial indicators over 15 years","volume":"23","author":"Hagens","year":"2020","journal-title":"Healthc. Q."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5395","DOI":"10.3390\/curroncol28060449","article-title":"Pivoting the provision of smoking cessation education in a virtual clinical world: The Princess Margaret Cancer Centre experience","volume":"28","author":"Quartey","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_14","unstructured":"Cancer Care Ontario (2022, February 15). Ontario Cancer Plan 5: 2019\u20132023, Available online: https:\/\/www.cancercareontario.ca\/en\/cancerplan."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/7\/365\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:40:47Z","timestamp":1760139647000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/7\/365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":14,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["curroncol29070365"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29070365","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]}}}