Integrating Tobacco Use Assessment and Treatment in the Oncology Setting - Quality Improvement Results from the Georgetown Lombardi Smoking Treatment and Recovery Program

Sep 24, 2026

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NCI’s Cancer Center Cessation (C3i) initiative supported the creation, expansion, and maintenance of an evidence-based tobacco treatment program at Georgetown Lombardi Comprehensive Cancer Center. A quality improvement assessment evaluated implementation processes and patient-level outcomes across two hematology/oncology outpatient sites. Five oncology-based teams developed strategies for opt-out assessment and enrollment, centralized treatment, audit and feedback, and staff training. Medical assistants screened 19,344 patients, identified 1,345 current users, and 301 enrolled; 199 engaged in treatment. Engagement and 6-month 7-day abstinence were driven by clinical and treatment factors, with inequities addressed through reach and engagement of a majority-African-American population. The opt-out assessment approach was later adopted through MedStar Health’s Commission on Cancer Just Ask program.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Introduction

Cancer and tobacco outcomes

The NCI Cancer Center Cessation Initiative (C3i)

The STAR Program at Georgetown Lombardi

Methods

Implementation teams and strategies

Opt-out assessment and enrollment

Treatment engagement and abstinence outcomes

Results

Screening and identification of tobacco users

Enrollment predictors

Treatment engagement and abstinence predictors

Discussion

Article Integrating Tobacco Use Assessment and Treatment in the Oncology Setting: Quality Improvement Results from the Georgetown Lombardi Smoking Treatment and Recovery Program Kathryn L. Taylor 1, *, Marguerite A. Webster 1, Joanna G. Philips 1,†, Julia M. Whealan 1, Tania Lobo 1, Kimberly M. Davis 1,2, Chavalia J. Breece 3,4, Jennifer R. Wheeley 5, Jack E. Childs 1, Ariel Q. Le 1, Randi M. Williams 1, Irina G. Veytsman 5 and Chul Kim 6 Citation: Taylor, K.L.; Webster, M.A.; Philips, J.G.; Whealan, J.M.; Lobo, T.; Davis, K.M.; Breece, C.J.; Wheeley, J.R.; Childs, J.E.; Le, A.Q.; et al. Integrating Tobacco Use Assessment and Treatment in the Oncology Setting: Quality Improvement Results from the Georgetown Lombardi Smoking Treatment and Recovery Program. Curr. Oncol. 2023, 30, 3755–3775. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/curroncol30040285](10.3390/curroncol30040285) Received: 3 January 2023 Revised: 7 March 2023 Accepted: 24 March 2023 Published: 28 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA 2 Department of Psychiatry, Georgetown University Hospital, MedStar Health, Washington, DC 20007, USA 3 Department of Pulmonary Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, USA 4 Department of Medical Oncology, MedStar Georgetown University Hospital, Washington, DC 20007, USA 5 Department of Medical Oncology, MedStar Washington Hospital Center, Washington, DC 20010, USA 6 Department of Medicine, Georgetown University Medical Center, Division of Hematology and Oncology, Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA * Correspondence: [taylorkl@georgetown.edu](taylorkl@georgetown.edu) † Current address: Patient Centered Outcomes Research Institute (PCORI), Washington, DC 20036, USA. Abstract: As part of the NCI's Cancer Center Cessation (C3i) initiative, we initiated, expanded, and maintained an evidence-based tobacco treatment program at the Georgetown Lombardi Comprehensive Cancer Center. We present a quality improvement (QI) assessment of the implementation process and patient-level outcomes. At two hematology/oncology outpatient clinical sites, ﬁve oncology-based teams (clinical administrators, clinical staff, pharmacy, information technology, and tobacco treatment staff) developed implementation strategies for opt-out patient assessment and enrollment, centralized tobacco treatment, audit, feedback, and staff training. Among eligible patients (tobacco use in 􀀔30 days), we assessed demographic, clinical, and tobacco-related characteristics to examine predictors of enrollment (baseline completed), treatment engagement (􀀕one sessions completed), and self-reported 7-day abstinence (6 months post-enrollment) . Across both sites, medical assistants screened 19,344 (82.4%) patients for tobacco use, which identiﬁed 1345 (7.0%) current tobacco users, in addition to 213 clinician referrals. Of the 687/1256 (54.7%) eligible patients reached, 301 (43.8%) enrolled, and 199 (29.0%) engaged in treatment, of whom 74.5% were African American and 68% were female. At the larger site, signiﬁcant multivariate predictors of enrollment included African American race (vs. white/other) and clinician referral (vs. MA assessment) . Treatment engagement was predicted by greater nicotine dependence, and abstinence (27.4%) was predicted by greater treatment engagement. In summary, the systematic utilization of multiple oncology-based teams and implementation strategies resulted in the developmen

FAQs

What program framework supported tobacco treatment at Georgetown Lombardi?

The tobacco treatment program was initiated, expanded, and maintained as part of the NCI Cancer Center Cessation (C3i) initiative, delivered through the Smoking Treatment and Recovery (STAR) Program.

How were eligible patients assessed and enrolled for tobacco treatment?

At two hematology/oncology outpatient sites, teams implemented an opt-out patient assessment and enrollment approach, with centralized tobacco treatment, audit and feedback, and staff training.

Which factors predicted enrollment, treatment engagement, and abstinence?

Enrollment was associated with African American race and clinician referral. Treatment engagement was predicted by greater nicotine dependence, and 6-month self-reported 7-day abstinence was predicted by greater treatment engagement.

Sep 24, 2026

Uploaded by Aria