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Working with Patients, Clients, Families and Communities

Never quit quitting

Archie Stewart

Archie Stewart, public advisor, Program of Care for Cancer and lung cancer patient

Archie Stewart began smoking at 13 when it was the cool thing to do. Although he tried to quit many times, it was 45 years later in 2008 – after being diagnosed with two different lung cancers – that he smoked his last cigarette.

“I probably quit 200 times before I quit for good,” said Stewart. “My advice to people who are interested in quitting – never quit quitting. Don’t stop. I speak from experience – on your worst day as a non-smoker you will feel better than on your best day as a smoker.”

On top of feeling better, patients who quit tobacco after being diagnosed with cancer:

  • · have fewer treatment and disease-related complications
  • · significantly improve the effectiveness of their cancer treatment
  • · improve their chances of survival
  • · lower their chances of the cancer coming back and developing new cancers.

“Imagine a new cancer drug that prevents death from cancer and makes people who are diagnosed with cancer live better and longer, cancer-free,” said Dr. Stephanie Snow, Medical Oncologist, QEII Health Sciences Centre, and a member of the project team. “Wouldn’t we all want that drug and do everything we could to access it? Tobacco cessation has all those benefits. As cancer health providers, we have a responsibility to share this powerful news with our patients and to support them in quitting tobacco. To do anything less, knowing what we know now, would not be quality care.”

Using this new evidence and funding from the Canadian Partnership Against Cancer, the Program of Care for Cancer has explored ways to:

  • · review the current capacity for tobacco cessation supports in cancer programs across the province
  • · increase awareness among health care providers about the benefits of tobacco cessation after a cancer diagnosis
  • · develop tools and resources for patients, their families and health care providers to support patients in efforts to quit
  • · share and build on learning from the Cape Breton Cancer Centre’s tobacco cessation outpatient program
  • With the exception of the Cape Breton Cancer Centre, baseline surveys in March 2016 indicated that cancer program sites had not prioritized tobacco cessation for cancer patients. Based on these findings and guidance from three patient/public advisors, including Archie, and a network of 14 patient ambassadors, health professionals with Mental Health and Addictions and cancer program sites across the province, as well as representatives from Department of Health and Wellness, the team developed educational resources for patients and providers, offered skill development workshops for cancer health professionals and Nicotine Addictions Specialists (Mental Health and Addictions) specific to cancer patients, encouraging cancer health providers to use supports available through 811/Tobacco Free Nova Scotia and make tobacco cessation an integral part of cancer treatment discussions with patients.

    Jenna Gay, Radiation Therapist at the Cape Breton Cancer Centre and a team member, said the patient voice was valuable in emphasizing the importance and value of tobacco cessation in cancer care. “Our public advisors have helped to ensure that the language and messages in our cessation support materials will hit home with patients who are tobacco users at the time of diagnosis.”

    Leveraging infrastructure already available, the team is promoting an “ask-advise-refer” approach where cancer health professionals ask patients about their tobacco use, advise patients on the benefits of quitting, in relation to their diagnosis and treatment and refer them to Tobacco Free Nova Scotia where they can access cessation counselling, other online supports or be connected to Mental Health and Addictions and a Nicotine Addictions Specialist.

    With the planning phase of the project complete, the next steps include continuing to work collaboratively with stakeholders and partners across the province to provide the necessary supports to patients, their families and health care providers to fully implement tobacco cessation as an essential part of the cancer treatment discussion between patients and providers.

    “Strengthening Cancer Centre Capacity to Integrate Evidence-based Tobacco Cessation Programming” funded by the Canadian Partnership Against Cancer through Health Canada
    Archie Stewart’s story in his own words is available at http://library.nshealth.ca/cancerandtobacco

    About tobacco:

    • · about 20 per cent of cancer patients in Canada reported as regular or occasional smokers in 2016; in Nova Scotia, about 1,200 smokers are diagnosed with cancer each year
    • · smoking causes 30 per cent of cancer deaths
    • · smoking causes up to 85 per cent of lung cancers
    • · smoking increases the risk of cancers of the mouth and throat, larynx, esophagus, pancreas, cervix, kidney, colorectum, liver, ovary and bladder

    For patients, the good news is, it is never too late to benefit from quitting. For health care providers, the message is simple: supporting your patients to be tobacco free is good medicine.

    Tobacco Cessation Supports in Nova Scotia

    • · Tobacco Free Nova Scotia (tobaccofree.novascotia.ca)
    • · Call 811 and speak with a Nicotine Addictions Specialist