Addressing disparities and barriers to care between Black and White cancer patients who use tobacco

Abstract Purpose of the study: Smoking is detrimental to treatment outcomes for both smoking and non-smoking-related cancers, and tobacco cessation is an integral part of comprehensive cancer care. Through the support of a competitive grant funded by the NCI’s Cancer Center Cessation Initiative, Fox Chase Cancer Center (FCCC) optimized their Tobacco Treatment Program (TTP). Within the first year of optimization, TTP’s reach increased tenfold by implementing an automated tobacco registry through a nightly EMR feed that proactively reaches all new cancer patients who have used tobacco in the last 30 days. This registry serves as a repository and referral source for the optimized program and includes demographic information and smoking status of all new patients who use tobacco. Within the first year of the program at FCCC, the registry was comprised of 70% white (W) and 20% black (B). FCCC TTP has since expanded to the broader Temple University Health System (TUHS) to increase smoking cessation and cancer prevention efforts within a predominantly underrepresented population that often face higher rates of tobacco use and barriers to quitting. Description: Patients are referred to TTP in 3 ways (survey from the tobacco registry, a provider referral from the newly implemented BPA, or self-referral from AVS and marketing materials in three languages). The TTP provides access to evidence-based smoking cessation resources, motivational interviewing with a health educator, treatment with Advanced Practice Tobacco Specialists, and access to NRTs. A REDCap Case Management System was utilized to collect programmatic data that includes scheduled TTP appointments, no-show rates, prescribing data, and readiness to quit. These data have allowed us to evaluate access disparities between B and W patients that will further be explored with the broader expansion to TUHS. Results: Within the first year of optimization, there were no significant differences in number of appointments, no-show rates, and NRT prescriptions between B and W patients. The maximum number of appointments for B patients was 9 compared to 11 W, and TTP had an overall no-show rate of 22% (W patients had a no-show rate of 23%, and B patients had a lower no-show rate of 15%). Additionally, 60% of W patients scheduled TTP visits compared to 50% of B patients. Over 85% of B/W patients were prescribed NRTs, and the breakdown of what was prescribed (patch, gum, lozenge, Chantix, Zyban) did not differ by race. Conclusions: While access to services is comparable in B/W populations, there may be approaches to increase B patients scheduling and explore access all patient populations, particularly as we expand our services throughout TUHS. We will examine barriers to scheduling appointments for B patients as they were less likely than W patients to schedule a TTP appointment. The expansion to TUHS will allow us to provide tobacco cessation and explore differences across sociodemographic factors and further explain utilization/access to TTP. Citation Format: Alison C. Brecher, Cassidy Kenny, Donna Edmondson, Allison Zambon, Linda Fleisher, Hossein Borghaei. Addressing disparities and barriers to care between Black and White cancer patients who use tobacco [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B002.