Smoking cessation in cancer care

Access to smoking cessation supports in cancer care settings in 2022-23

  • All 14 regional cancer centres in Ontario offer people with cancer support to quit smoking and 12 centres offer culturally appropriate supports to First Nations, Inuit and Métis and urban Indigenous peoples with cancer, such as through Indigenous Navigators. Tobacco-Wise Leads work across the province to provide culturally appropriate supports to First Nations, Inuit, Métis and urban Indigenous people. The Talk Tobacco helpline is also available to support Indigenous people in Ontario.
  • Staff at cancer centres screen people for commercial tobacco use, advise them to quit smoking, and using an opt-out approach, provide people with a referral to on-site or community-based smoking cessation services, such as the provincial quitline.
  • Free or low-cost smoking cessation medications are available in some cancer centres. Free nicotine replacement therapy (NRT) is also available to Ontario residents through the STOP on the Net program, the Moving On to Being Free Program, and the Ottawa Model for Smoking Cessation Program.

Smoking cessation in cancer care implementation level in 2022-23: GOLD

Quality dimension Implementation criteria met Level
Behavioural counselling Offers 3A (Ask, Advise, Act) or 5A (Ask, Advise, Assess, Assist, Arrange) model with an opt-out approach  SILVER
Pharmacotherapy Offers subsidized varenicline, bupropion and/or NRT  SILVER
Person-centred Engages people with cancer in program planning, gathers people’s feedback, and evaluates outcomes of people with cancer  GOLD
Culturally competent Offers staff cultural competency training and resources for people with cancer  SILVER
Partnership Works with a multi-disciplinary team and community partners  SILVER
Indicator measurement and reporting Collects and reports on adoption, reach, uptake and outcome data  GOLD

Smoking Cessation Action Framework Implementation Checklist

Impact of funded project (2019-22)

  • Building on a previously funded implementation project, funding and support enabled Ontario Health to enhance smoking cessation supports in cancer care programs. They did this by piloting a survey in two regional cancer centres that measured and reported on people’s smoking cessation outcomes such as whether they had quit smoking; the survey provided healthcare providers additional opportunities to refer people to smoking cessation services. One centre also piloted a voluntary Indigenous self-identification question, so that Indigenous Navigators could be notified in real time.
  • Ontario Health evaluated the acceptability of the survey, its helpfulness to healthcare providers and its impact on care and clinical workflow. The lessons learned from the pilot are informing the implementation of the survey across the province.
  • Additional funds received during the pandemic enabled Ontario Health to develop new educational resources on smoking, COVID-19 and cancer, and an online module to connect people with cancer to virtual smoking cessation supports.

Ontario cancer care settings offering smoking cessation remained at 14 out of 14 from 2018-19 to 2022-23. The implementation level went from silver in 2019-20 to gold in 2022-23.