Grant Number:	5R35CA197573-10 Interpret this number
Primary Investigator:	Fiore, Michael
Organization:	University Of Wisconsin-Madison
Project Title:	Leveraging the National Cancer Institute’s Cancer Center Cessation Initiative (C3I) Program to Evaluate and Transform Smoking Cessation Treatment in Cancer Care
Fiscal Year:	2024

PROJECT SUMMARY/ABSTRACT Cigarette smoking is both common and undertreated among oncology patients. Although smoking is a leading cause of cancer and results in worse cancer prognoses, only half of cancer patients who smoke are offered help in quitting during cancer care, and it is unclear that the help they are offered is effective. This R35 proposal is designed to transform oncology practice so that smoking cessation is an integral part of treatment for all cancer patients who smoke. Electronic health records (EHRs) have tremendous potential to accelerate improvements in clinical care by facilitating such treatment delivery. EHR modifications can also increase discovery by enhancing assessment of smoking treatment reach, costs, equity, and effectiveness both in terms of helping patients quit and improving cancer outcomes. The Principal Investigator has 30 years of experience leading research and policy efforts to promote the treatment of smoking. Over the past 7 years, he has led a team that developed and evaluated new EHR-based tools and workflows that markedly increase the proportion of adult patients who receive evidence-based smoking cessation treatment in primary care. The new R35 proposal will similarly identify intervention strategies that increase smoking treatment engagement and effectiveness when implemented in oncologic care. Over the last 4 years, the Principal Investigator has served as Senior Scientist for NCI’s Moonshot-supported Cancer Center Cessation Initiative (C3I), a nationwide effort of 52 NCI-designated cancer centers to develop and implement programs to aid their patients who smoke. Yet, this incredibly important initiative has not been systematically assessed in terms of which EHR-enabled interventions enhance a smoking program’s reach, patient engagement, implementation, cessation effectiveness, and benefits. This R35 renewal is designed to do just that by systematically assessing best practices via EHR data extraction of intervention delivery, healthcare costs, short-term cancer treatment outcomes overall, and by patient demographics. These EHR data will be supplemented by qualitative analysis of C3I smoking treatment components, delivery, adaptations, and contexts in a mixed-methods approach. Higher- and lower-performing smoking treatment programs will be identified and rigorous methods will then be used to select best practice programs from cessation- and cost-effectiveness perspectives. Further assessment will identify implementation strategies and contextual factors that may contribute to the effectiveness of these programs. Best practices from these programs will be implemented in lower-performing C3I programs, with research team support in adaptation and implementation. Pragmatic implementation guides and strategies will be used to disseminate best practices to cancer care programs nationwide. Thus, the proposed project seeks to extend and adapt transformative EHR-facilitated system changes that enhance smoking treatment in primary care to the high-priority cancer care context. The project will demonstrate the benefits of such system changes to cancer patients in terms of costs, smoking cessation, and cancer recovery.




Cost-Effectiveness of a Comprehensive Primary Care Smoking Treatment Program.
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PMID: 37844710
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Data envelopment analysis to evaluate the efficiency of tobacco treatment programs in the NCI Moonshot Cancer Center Cessation Initiative.
Authors: Pluta K. , Hohl S.D. , D'Angelo H. , Ostroff J.S. , Shelley D. , Asvat Y. , Chen L.S. , Cummings K.M. , Dahl N. , Day A.T. , et al. .
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PMID: 37170381
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Using information technology to integrate tobacco use treatment in routine oncology care: Lessons learned from the U.S. Cancer Center Cessation Initiative Cancer Centers.
Authors: Bird J.E. , Nguyen C.V. , Hohl S.D. , D'Angelo H. , Pauk D. , Adsit R.T. , Fiore M. , Minion M. , McCarthy D. , Rolland B. .
Source: Implementation Research And Practice, 2023 Jan-Dec; 4, p. 26334895231185374.
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Integrating Tobacco Treatment Into Oncology Care: Reach and Effectiveness of Evidence-Based Tobacco Treatment Across National Cancer Institute-Designated Cancer Centers.
Authors: Hohl S.D. , Matulewicz R.S. , Salloum R.G. , Ostroff J.S. , Baker T.B. , Schnoll R. , Warren G. , Bernstein S.L. , Minion M. , Lenhoff K. , et al. .
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Authors: McCarthy D.E. , Baker T.B. , Zehner M.E. , Adsit R.T. , Kim N. , Zwaga D. , Coates K. , Wallenkamp H. , Nolan M. , Steiner M. , et al. .
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Electronic health record closed-loop referral ("eReferral") to a state tobacco quitline: a retrospective case study of primary care implementation challenges and adaptations.
Authors: Zehner M.E. , Kirsch J.A. , Adsit R.T. , Gorrilla A. , Hayden K. , Skora A. , Rosenblum M. , Baker T.B. , Fiore M.C. , McCarthy D.E. .
Source: Implementation Science Communications, 2022-10-08 00:00:00.0; 3(1), p. 107.
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Can inpatient pharmacists move the needle on smoking cessation? Evaluating reach and representativeness of a pharmacist-led opt-out smoking cessation intervention protocol for hospital settings.
Authors: Creswell P.D. , McCarthy D.E. , Trapskin P. , Sheehy A. , Skora A. , Adsit R.T. , Zehner M.E. , Baker T.B. , Fiore M.C. .
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Development of a Pharmacist-Led Opt-Out Cessation Treatment Protocol for Combustible Tobacco Smoking Within Inpatient Settings.
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Quantifying rural disparity in healthcare utilization in the United States: Analysis of a large midwestern healthcare system.
Authors: Nuako A. , Liu J. , Pham G. , Smock N. , James A. , Baker T. , Bierut L. , Colditz G. , Chen L.S. .
Source: Plos One, 2022; 17(2), p. e0263718.
EPub date: 2022-02-10 00:00:00.0.
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Providing cessation treatment to every oncology patient who smokes: An essential component of cancer care.
Authors: Fiore M.C. , Baker T.B. , Nolan M.B. , Emamekhoo H. .
Source: Cancer, 2021-12-07 00:00:00.0; , .
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Cost-effectiveness of stop smoking incentives for medicaid-enrolled pregnant women.
Authors: Mundt M.P. , Fiore M.C. , Piper M.E. , Adsit R.T. , Kobinsky K.H. , Alaniz K.M. , Baker T.B. .
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Point of care tobacco treatment sustains during COVID-19, a global pandemic.
Authors: Craig E.J. , Ramsey A.T. , Baker T.B. , James A.S. , Luke D.A. , Malone S. , Chen J. , Pham G. , Smock N. , Goldberg P. , et al. .
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Ten Million Calls and Counting: Progress and Promise of Tobacco Quitlines in the U.S.
Authors: Fiore M.C. , Baker T.B. .
Source: American Journal Of Preventive Medicine, 2021 03; 60(3 Suppl 2), p. S103-S106.
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Closed-Loop Electronic Referral From Primary Care Clinics to a State Tobacco Cessation Quitline: Effects Using Real-World Implementation Training.
Authors: Baker T.B. , Berg K.M. , Adsit R.T. , Skora A.D. , Swedlund M.P. , Zehner M.E. , McCarthy D.E. , Glasgow R.E. , Fiore M.C. .
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Who are we missing with EHR-Based Smoking Cessation Treatments? A Descriptive Study of Patients who Smoke and Do Not Regularly Visit Primary Care Clinics.
Authors: Nolan M. , Zwaga D. , McCarthy D. , Kastman C. , Baker T. , Zehner M. , Smith S. , Fiore M. .
Source: Journal Of Smoking Cessation, 2020 Dec; 15(4), p. 175-180.
EPub date: 2020-09-03 00:00:00.0.
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Financial incentives to Medicaid smokers for engaging tobacco quit line treatment: maximising return on investment.
Authors: Mundt M.P. , Baker T.B. , Piper M.E. , Smith S.S. , Fraser D.L. , Fiore M.C. .
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PMID: 31147478
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Low Burden Strategies Are Needed to Reduce Smoking in Rural Healthcare Settings: A Lesson from Cancer Clinics.
Authors: Ramsey A.T. , Baker T.B. , Pham G. , Stoneking F. , Smock N. , Colditz G.A. , James A.S. , Liu J. , Bierut L.J. , Chen L.S. .
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Authors: Akhtar W.Z. , Mundt M.P. , Koepke R. , Krechel S. , Fiore M.C. , Seal D.W. , Westergaard R.P. .
Source: Jama Network Open, 2020-03-02 00:00:00.0; 3(3), p. e200493.
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Source: Journal Of The American Medical Informatics Association : Jamia, 2019-08-01 00:00:00.0; 26(8-9), p. 778-786.
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Addressing a Core Gap in Cancer Care - The NCI Moonshot Program to Help Oncology Patients Stop Smoking.
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Source: The New England Journal Of Medicine, 2019-02-07 00:00:00.0; 380(6), p. 512-515.
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Authors: Mundt M.P. , Baker T.B. , Fraser D.L. , Smith S.S. , Piper M.E. , Fiore M.C. .
Source: Value In Health : The Journal Of The International Society For Pharmacoeconomics And Outcomes Research, 2019 02; 22(2), p. 177-184.
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Source: Journal Of Smoking Cessation, 2018 Sep; 13(3), p. 145-153.
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Helping Smokers with Severe Mental Illness Who Do Not Want to Quit.
Authors: Christiansen B.A. , Carbin J. , TerBeek E. , Fiore M.C. .
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EPub date: 2017-11-21 00:00:00.0.
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A Randomized Trial of Incentives for Smoking Treatment in Medicaid Members.
Authors: Fraser D.L. , Fiore M.C. , Kobinsky K. , Adsit R. , Smith S.S. , Johnson M.L. , Baker T.B. .
Source: American Journal Of Preventive Medicine, 2017 Dec; 53(6), p. 754-763.
EPub date: 2017-11-02 00:00:00.0.
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Implementing Clinical Research Using Factorial Designs: A Primer.
Authors: Baker T.B. , Smith S.S. , Bolt D.M. , Loh W.Y. , Mermelstein R. , Fiore M.C. , Piper M.E. , Collins L.M. .
Source: Behavior Therapy, 2017 Jul; 48(4), p. 567-580.
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Longitudinal Impact Of Smoking And Smoking Cessation On Inflammatory Markers Of Cardiovascular Disease Risk
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Source: Arteriosclerosis, Thrombosis, And Vascular Biology, 2017 Feb; 37(2), p. 374-379.
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Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2016 Aug; 18(8), p. 1684-96.
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Authors: Adsit R. , Wisinski K. , Mattison R. , Bailey H. , Fiore M. .
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Authors: Baker T.B. , Piper M.E. , Stein J.H. , Smith S.S. , Bolt D.M. , Fraser D.L. , Fiore M.C. .
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Withdrawal: Expanding a Key Addiction Construct.
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Defining and predicting short-term alcohol use changes during a smoking cessation attempt.
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