Abstract

Bonnie Bristow, Arlene Court, Elaine Curle, Leslie Gibson, Margaret Fitch, Andrea Eisen, Lisa DiProspero
Odette Cancer Centre, Toronto, ON

Purpose: Evidence shows that lung cancer patients who quit smoking may have a better outcome than those who continue to smoke. Health care professionals (HCP) were concerned that asking patients with lung cancer about tobacco use and intentions to quit smoking could potentially increase stigma, shame, and blame. This study explored the perspectives of patients with lung cancer and health care professionals who provided direct care to patients with lung cancer, regarding tobacco use and smoking cessation. It sought to understand similarities and differences in perspectives in order to inform patient centred approaches to offering smoking cessation services. 

Materials and Methods: This study utilized a qualitative descriptive method two phased approach. Phase I: three health care professional focus groups were held. Phase II: 19 semi- structured patient interviews were completed. All patient interviews and focus groups were audio recorded and transcribed verbatim. Inclusion criteria for patients included: diagnosis of lung cancer, currently smoking or have smoked in the past. Multiple readings of each focus group and patient interview transcript were performed using narrative thematic analysis to identify major themes. Participants were provided with the opportunity to deepen their understanding of the patient perspective and reflect upon their personally held assumptions and values. One final focus group for HCP will occur as a member check.

Results: Findings from the HCP focus groups highlighted emerging themes relating to: Identification of smokers (Triggers to start a conversation and Consistency of approach), HCP perception of patient’s receptivity (Judgement and Rapport), Rationale for smoking cessation (Repetition and reinforcement during treatment, Palliative patients, Addiction) and Barriers to practice (Staff setting an example, Follow-up)

Conclusions: Findings from this study will support and guide a patient centred approach to smoking cessation best practices, effective communication strategies, and full implementation of the Smoking Cessation Program in the Lung Site.