{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:06:21Z","timestamp":1781517981510,"version":"3.54.1"},"reference-count":50,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Cancer Institute Moonshot Initiative: Administrative Supplement","award":["P30 CA1244351-13S2"],"award-info":[{"award-number":["P30 CA1244351-13S2"]}]},{"name":"National Cancer Institute Moonshot Initiative: Administrative Supplement","award":["P30CA1244351-12S1"],"award-info":[{"award-number":["P30CA1244351-12S1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Smoking causes one in three cancer deaths and may worsen COVID-19 outcomes. Telehealth tobacco cessation treatment is offered as a covered benefit for patients at the Stanford Cancer Center. We examined predictors of engagement during the COVID-19 pandemic. Data were abstracted from the Electronic Health Record between 3\/17\/20 (start of pandemic shelter-in-place) and 9\/20\/22, including patient tobacco use, demographics, and engagement in cessation treatment. Importance of quitting tobacco was obtained for a subset (53%). During the first 2.5 years of the pandemic, 2595 patients were identified as recently using tobacco, and 1571 patients were contacted (61%). Of the 1313 patients still using tobacco (40% women, mean age 59, 66% White, 13% Hispanic), 448 (34%) enrolled in treatment. Patient engagement was greater in pandemic year 1 (42%) than in year 2 (28%) and year 3 (19%). Women (41%) engaged more than men (30%). Patients aged 36\u201345 (39%), 46\u201355 (43%), 56\u201365 (37%), and 66\u201375 (33%) engaged more than patients aged 18\u201335 (18%) and &gt;75 (21%). Hispanic\/Latinx patients (42%) engaged more than non-Hispanic\/Latinx patients (33%). Engagement was not statistically significantly related to patient race. Perceived importance of quitting tobacco was significantly lower in pandemic year 1 than year 2 or 3. Nearly one in three cancer patients engaged in telehealth cessation treatment during the COVID-19 pandemic. Engagement was greater earlier in the pandemic, among women, Hispanic\/Latinx individuals, and patients aged 36 to 75. Sheltering-in-place, rather than greater perceived risk, may have facilitated patient engagement in tobacco cessation treatment.<\/jats:p>","DOI":"10.3390\/ijerph21020131","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T03:59:42Z","timestamp":1706155182000},"page":"131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictors of Patient Engagement in Telehealth-Delivered Tobacco Cessation Treatment during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8893-507X","authenticated-orcid":false,"given":"Annemarie D.","family":"Jagielo","sequence":"first","affiliation":[{"name":"PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA 94304, USA"},{"name":"Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Chieng","sequence":"additional","affiliation":[{"name":"Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-772X","authenticated-orcid":false,"given":"Cindy","family":"Tran","sequence":"additional","affiliation":[{"name":"Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Pirkl","sequence":"additional","affiliation":[{"name":"Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Cao-Nasalga","sequence":"additional","affiliation":[{"name":"Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Bragg","sequence":"additional","affiliation":[{"name":"Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachelle","family":"Mirkin","sequence":"additional","affiliation":[{"name":"Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7925-326X","authenticated-orcid":false,"given":"Judith J.","family":"Prochaska","sequence":"additional","affiliation":[{"name":"Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"(2008). A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 Update. Am. J. Prev. Med., 35, 158\u2013176.","DOI":"10.1016\/j.amepre.2008.04.009"},{"key":"ref_2","unstructured":"CDCTobaccoFree (2023, June 11). 2014 Surgeon General\u2019s Report: The Health Consequences of Smoking\u201450 Years of Progress. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/tobacco\/sgr\/50th-anniversary\/index.htm."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1245\/s10434-011-2128-y","article-title":"Adverse Effects of Smoking on Postoperative Outcomes in Cancer Patients","volume":"19","author":"Gajdos","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1634\/theoncologist.2011-0169","article-title":"The Effect of Cigarette Smoking on Cancer Treatment\u2013Related Side Effects","volume":"16","author":"Peppone","year":"2011","journal-title":"Oncologist"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S50","DOI":"10.21037\/tlcr.2019.04.01","article-title":"Tobacco Smoking after Diagnosis of Cancer: Clinical Aspects","volume":"8","author":"Jassem","year":"2019","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_6","unstructured":"(2023, June 11). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1093\/ntr\/ntaa082","article-title":"Smoking Is Associated With COVID-19 Progression: A Meta-Analysis","volume":"22","author":"Patanavanich","year":"2020","journal-title":"Nicotine Tob. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1002\/jmv.26389","article-title":"The Effect of Smoking on COVID-19 Severity: A Systematic Review and Meta-analysis","volume":"93","author":"Reddy","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"106237","DOI":"10.1016\/j.rmed.2020.106237","article-title":"Smoking and COVID-19: What We Know so Far","volume":"176","author":"Shastri","year":"2021","journal-title":"Respir. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Yingst, J.M., Krebs, N.M., Bordner, C.R., Hobkirk, A.L., Allen, S.I., and Foulds, J. (2021). Tobacco Use Changes and Perceived Health Risks among Current Tobacco Users during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18041795"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.amepre.2021.08.018","article-title":"Smoking and E-Cigarette Use Among U.S. Adults During the COVID-19 Pandemic","volume":"62","author":"Kalkhoran","year":"2022","journal-title":"Am. J. Prev. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1159\/000515438","article-title":"The Effects of the Lockdown during the COVID-19 Pandemic on Alcohol and Tobacco Consumption Behavior in Germany","volume":"27","author":"Koopmann","year":"2021","journal-title":"Eur. Addict. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1093\/ntr\/ntaa257","article-title":"Changes in Tobacco Use During the 2020 COVID-19 Lockdown in New Zealand","volume":"23","author":"Gendall","year":"2021","journal-title":"Nicotine Tob. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1093\/ntr\/ntab053","article-title":"Perceptions of Tobacco Product-Specific COVID-19 Risk and Changes in Tobacco Use Behaviors Among Smokers, E-Cigarette Users, and Dual Users","volume":"23","author":"White","year":"2021","journal-title":"Nicotine Tob. Res."},{"key":"ref_15","unstructured":"(2023, June 15). Smoking Cessation\u2014The Role of Healthcare Professionals and Health Systems, Available online: https:\/\/www.cdc.gov\/tobacco\/sgr\/2020-smoking-cessation\/fact-sheets\/healthcare-professionals-health-systems\/index.html."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e721","DOI":"10.1200\/OP.21.00458","article-title":"Demographic and Clinical Predictors of Engaging in Tobacco Cessation Counseling at a Comprehensive Cancer Center","volume":"18","author":"Zanotti","year":"2022","journal-title":"JCO Oncol. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1158\/1055-9965.EPI-06-0791","article-title":"Predictors of Participation in a Smoking Cessation Program among Young Adult Smokers","volume":"16","author":"Rodriguez","year":"2007","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1017\/jsc.2020.7","article-title":"Predictors of Participant \u2018No-Shows\u2019 for Intensive Behavioral Tobacco Cessation Treatment: Recruitment, Demographics, and Distance","volume":"15","author":"Sirody","year":"2020","journal-title":"J. Smok. Cessat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.2105\/AJPH.2007.112060","article-title":"Smoking Cessation Rates in the United States: A Comparison of Young Adult and Older Smokers","volume":"98","author":"Messer","year":"2008","journal-title":"Am. J. Public Health"},{"key":"ref_20","unstructured":"CDC (2023, December 09). Current Cigarette Smoking Among Adults in the United States. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/adult_data\/cig_smoking\/index.htm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1089\/heq.2020.0157","article-title":"Achieving Equity in the Reach of Smoking Cessation Services Within the NCI Cancer Moonshot-Funded Cancer Center Cessation Initiative","volume":"5","author":"Burris","year":"2021","journal-title":"Health Equity"},{"key":"ref_22","first-page":"261","article-title":"Predictors of Long-Term Smoking Cessation in Head and Neck Cancer Patients","volume":"2","author":"Gritz","year":"1993","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1002\/hed.10368","article-title":"Comparing Cancer Patients Who Enroll in a Smoking Cessation Program at a Comprehensive Cancer Center with Those Who Decline Enrollment","volume":"26","author":"Schnoll","year":"2004","journal-title":"Head Neck"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1093\/ntr\/ntaa051","article-title":"Predictors of Smoking Cessation Attempts and Success Following Motivation-Phase Interventions Among People Initially Unwilling to Quit Smoking","volume":"22","author":"Klemperer","year":"2020","journal-title":"Nicotine Tob. Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Gali, K., Pike, B., Kendra, M.S., Tran, C., Fielding-Singh, P., Jimenez, K., Mirkin, R., and Prochaska, J.J. (2020). Integration of Tobacco Treatment Services into Cancer Care at Stanford. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17062101"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/add.12734","article-title":"It\u2019s Time to Change the Default for Tobacco Treatment: Changing the Default","volume":"110","author":"Richter","year":"2015","journal-title":"Addiction"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1001\/jamainternmed.2022.7170","article-title":"The Effects of Opt-out vs Opt-in Tobacco Treatment on Engagement, Cessation, and Costs: A Randomized Clinical Trial","volume":"183","author":"Richter","year":"2023","journal-title":"JAMA Intern. Med."},{"key":"ref_28","unstructured":"Bates-Pappas, G.E., Ostroff, J., Lui, M., Chichester, L.E., Kosten, C., Carter-Bawa, L.M., Whitlock, C., and O\u2019Brien, M.G. (2023, June 11). An Opt-Out Referral Strategy Mitigates Racial and Ethnic Disparities in Referral and Engagement of Cancer Patients in Tobacco Treatment Services. Presented at the Scientific Forum for Presentation and Respectful Discussion of Cutting-Edge Nicotine and Tobacco Research, San Antonio, TX, USA, 1\u20134 March 2023. Available online: https:\/\/cdn.ymaws.com\/www.srnt.org\/resource\/resmgr\/conferences\/2023_annual_meeting\/documents\/SRNT23_Abstracts022423.pdf."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1080\/02791072.2021.1977874","article-title":"Racial\/Ethnic Differences in Tobacco Use and Cessation Services among Individuals in Substance Use Treatment","volume":"53","author":"McCuistian","year":"2021","journal-title":"J. Psychoact. Drugs"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.6004\/jnccn.2021.7093","article-title":"Sustainability of tobacco treatment programs in the cancer center cessation initiative","volume":"19","author":"Salloum","year":"2021","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s43058-021-00144-7","article-title":"Mixed-Methods Economic Evaluation of the Implementation of Tobacco Treatment Programs in National Cancer Institute-Designated Cancer Centers","volume":"2","author":"Salloum","year":"2021","journal-title":"Implement. Sci. Commun."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Schapira, L. (2022). Essentials of Cancer Survivorship: A Guide for Medical Professionals, CRC Press.","DOI":"10.1201\/9781003055426"},{"key":"ref_33","unstructured":"(2023, September 11). Cancer MoonshotSM\u2014NCI, Available online: https:\/\/www.cancer.gov\/research\/key-initiatives\/moonshot-cancer-initiative."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1056\/NEJMp1813913","article-title":"Addressing a Core Gap in Cancer Care\u2014The NCI Moonshot Program to Help Oncology Patients Stop Smoking","volume":"380","author":"Croyle","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1158\/1940-6207.CAPR-19-0182","article-title":"Tobacco Treatment Program Implementation at NCI Cancer Centers: Progress of the NCI Cancer Moonshot-Funded Cancer Center Cessation Initiative","volume":"12","author":"Rolland","year":"2019","journal-title":"Cancer Prev. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.6004\/jnccn.2016.0153","article-title":"Tobacco Cessation Treatment Pathways for Patients With Cancer: 10 Years in the Making","volume":"14","author":"Oughli","year":"2016","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3747\/co.26.5201","article-title":"Implementation of a Comprehensive Smoking Cessation Program in Cancer Care","volume":"26","author":"Abdelmutti","year":"2019","journal-title":"Curr. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1016\/j.jaip.2020.04.039","article-title":"Exercise and Fitness in the Age of Social Distancing During the COVID-19 Pandemic","volume":"8","author":"Nyenhuis","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1200\/GO.20.00639","article-title":"Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review","volume":"7","author":"Riera","year":"2021","journal-title":"JCO Glob. Oncol."},{"key":"ref_40","unstructured":"(2023, June 15). Are There Gender Differences in Tobacco Smoking? National Institutes of Health, Available online: https:\/\/nida.nih.gov\/publications\/research-reports\/tobacco-nicotine-e-cigarettes\/are-there-gender-differences-in-tobacco-smoking."},{"key":"ref_41","unstructured":"(2023, September 23). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db380.htm."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.amepre.2012.02.013","article-title":"Efficacy of Smoking-Cessation Interventions for Young Adults","volume":"42","author":"Suls","year":"2012","journal-title":"Am. J. Prev. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e018150","DOI":"10.1136\/bmjopen-2017-018150","article-title":"What Are Older Smokers\u2019 Attitudes to Quitting and How Are They Managed in Primary Care? An Analysis of the Cross-Sectional English Smoking Toolkit Study","volume":"7","author":"Jordan","year":"2017","journal-title":"BMJ Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/ageing\/afm119","article-title":"Smoking Cessation and Transition into Retirement: Analyses from the English Longitudinal Study of Ageing","volume":"36","author":"Lang","year":"2007","journal-title":"Age Ageing"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/eurpub\/ckt157","article-title":"Retirement and a Healthy Lifestyle: Opportunity or Pitfall? A Narrative Review of the Literature","volume":"24","author":"Zantinge","year":"2014","journal-title":"Eur. J. Public Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/j.1365-2524.2006.00659.x","article-title":"Smoking after the Age of 65 Years: A Qualitative Exploration of Older Current and Former Smokers\u2019 Views on Smoking, Stopping Smoking, and Smoking Cessation Resources and Services: Smoking after the Age of 65 Years","volume":"14","author":"Kerr","year":"2006","journal-title":"Health Soc. Care Community"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1111\/jgs.16845","article-title":"Rapid Integration of Home Telehealth Visits Amidst COVID-19: What Do Older Adults Need to Succeed?","volume":"68","author":"Hawley","year":"2020","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"190279","DOI":"10.5888\/pcd17.190279","article-title":"Disparities in Cessation Behaviors Between Hispanic and Non-Hispanic White Adult Cigarette Smokers in the United States, 2000\u20132015","volume":"17","author":"Babb","year":"2020","journal-title":"Prev. Chronic Dis."},{"key":"ref_49","first-page":"CD008286","article-title":"Combined Pharmacotherapy and Behavioural Interventions for Smoking Cessation","volume":"2016","author":"Stead","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s10488-006-0040-8","article-title":"Latino Adults\u2019 Access to Mental Health Care: A Review of Epidemiological Studies","volume":"33","author":"Cabassa","year":"2006","journal-title":"Adm. Policy Ment. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/2\/131\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:48:55Z","timestamp":1760104135000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/2\/131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":50,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["ijerph21020131"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21020131","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}