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Purpose: To address challenges promoting tobacco cessation in oncology settings, it is important to understand characteristics associated with patient engagement in tobacco cessation treatment. This analysis examined predictors of participating in at least one tobacco cessation counseling session among patients referred to a comprehensive cancer center's Tobacco Intervention and Psychosocial Support (TIPS) service., Methods: Patients with cancer who reported current smoking or recently quitting and referred to TIPS between June 2017 and February 2020 were included in the analysis. Independent variables included sex, race and ethnicity, insurance type, cancer diagnosis (tobacco-related or not), age, nicotine dependence, and cigarettes smoked per day at baseline. The outcome variable was completion of at least one tobacco cessation counseling session among those assessed by the TIPS program. Unadjusted and adjusted analyses tested associations between the independent variables and tobacco cessation counseling engagement., Results: Of 360 oncology patients referred to the TIPS program, 224 (62.2%) were assessed and 120 (33%) engaged in at least one counseling session. After controlling for sociodemographics and tobacco use, the results demonstrated that patients diagnosed with tobacco-related cancers were 45.3% less likely to engage in the tobacco cessation program compared with those with non-tobacco-related cancers ( P = .041)., Conclusion: Patients diagnosed with tobacco-related cancers were less likely to engage in TIPS. Additional therapeutic resources may be needed to engage these patients to address potential explanatory factors, such as stigma, guilt, and fatalism. More research is needed to explore the impact of a tobacco-related cancer diagnosis on treatment engagement., Competing Interests: Richard T. LeeResearch Funding: Merck (Inst), Incyte (Inst), Yivia (Inst)Uncompensated Relationships: Grow Ohio PharmaceuticalsNo other potential conflicts of interest were reported.

Purpose: To explore (1) perceptions of tobacco cessation for patients, (2) perceived role in addressing patients' tobacco use, (3) facilitators and barriers to providing cessation services, and (4) perceptions and use of tobacco cessation resources among oncology providers., Methods: Interviews were conducted with 24 oncology providers at a National Cancer Institute-Designated Comprehensive Cancer Center. Qualitative themes were analyzed using content analysis., Results: Participants (1) perceived smoking cessation's priority as low and/or dependent upon clinical factors, (2) described a passive role in addressing tobacco cessation, (3) described loss-framed versus gain-framed messaging when delivering cessation advice, (4) reported moderate self-efficacy in discussing and low self-efficacy in implementing cessation strategies, (5) described multi-level facilitators and barriers to patients' tobacco cessation, and (6) expressed high value for the cancer center's tobacco cessation service., Conclusion: Oncology providers in this study perceived patients' tobacco cessation as a low priority relative to providing direct cancer treatment and addressing acute complications. These findings indicate opportunities for training to increase delivery of evidence-based cessation advice and facilitate patients' engagement in cessation services. Provider trainings on embracing an active role in tobacco cessation, addressing multi-level barriers to patients' tobacco cessation, and using gain-framed messaging should be implemented. This has the potential to improve cancer patients' treatment outcomes.