Exploring Practices for Implementing Smoking Cessation in Oncology Settings: A Rapid Systematic Review Update

Introduction Smoking cessation among individuals with cancer increases the effectiveness of cancer treatments and reduces the risks of death. However, individuals receiving cancer treatments in Ontario’s 14 regional cancer centres are provided advice on the benefits of quitting smoking and referrals to smoking cessation treatments at different rates. This rapid systematic review was conducted, with funding from the Canadian Cancer Society, to update a published systematic review (Young et al, 2023) and to (1) identify implementation strategies and related implementation outcomes used in oncology settings; (2) describe the characteristics of these implementation strategies and implementation outcomes; and (3) determine whether specific implementation strategies are associated with increased smoking cessation efforts, referred to as the 3As (Ask, Advise, and Act) approach to smoking cessation. Methods This rapid systematic review was registered in The International Prospective Register of Systematic Reviews (registration number CRD42023491391). Three databases were searched for relevant studies: MEDLINE, Embase, and Cochrane Library. The quality of included studies was assessed based on their study design and narrative synthesis was used to summarize the data extracted. Results 3158 studies were found, and eighteen new studies met our inclusion criteria. All eighteen studies had a low to moderate risk of bias. The implementation strategies training and educating stakeholders, using evaluative and iterative strategies, providing interactive assistance, supporting clinicians, and developing stakeholder interrelationships were associated with increased asking, advising, and acting, although these associations do not imply causality. Only 5 studies measured implementation outcomes; however, heterogeneity in the measurement tools used prevented analysis. Conclusion Although abundant data on implementation strategies was found, implementation outcomes were sparse and connections between the implementation strategies and implementation outcomes could not be drawn. Future studies should pilot the implementation strategies associated with increased asking, advising, and acting, and measure their success, considering both implementation strategies and implementation outcomes, as this information is lacking in the current literature.