Phoenix rising from a cigarette surrounded by flowers, symbolizing smoking cessation and hope for breast cancer patients.

Breaking Barriers: How to Seamlessly Integrate Smoking Cessation into Breast Cancer Care

Rhea Morgan in Health & Wellness December 2025 • 4 min read.

"A practical guide for healthcare providers to improve smoking cessation referrals and outcomes in breast cancer patients."

Smoking significantly hampers recovery and outcomes for patients undergoing breast reconstruction after breast cancer. Though the benefits of quitting are clear, integrating smoking cessation support into standard cancer treatment has been a persistent challenge. Many patients miss out on vital resources due to various systemic and practical obstacles.

A recent study published in Supportive Care in Cancer sheds light on a successful intervention designed to tackle this issue head-on. Researchers focused on creating a streamlined referral process within a breast cancer clinic to ensure that every smoking patient receives consistent access to tobacco treatment services.

This article breaks down the study's key findings and offers a practical roadmap for healthcare providers aiming to replicate this success in their own practices. By understanding the strategies and addressing the common barriers, you can play a pivotal role in improving the health and well-being of your patients.

The Intervention: Designing a Seamless Referral Process

Phoenix rising from a cigarette surrounded by flowers, symbolizing smoking cessation and hope for breast cancer patients.

The study began with a thorough assessment of existing referral practices at the Mayo Breast Clinic. Researchers analyzed patient records to understand the current rates of smoking documentation, advice given, referral to the Nicotine Dependence Center (NDC), and actual attendance at NDC appointments. This baseline data revealed significant gaps in the referral process.

Based on these insights, the team designed a multi-faceted intervention with the goal of making smoking cessation a standard part of breast cancer care. Key elements of the intervention included:

Consistent Documentation: Ensuring that smoking status was consistently recorded at every stage of the patient's journey.
Provider Education: Equipping physicians and nurse practitioners with specific talking points about the benefits of quitting, tailored to the context of cancer care.
"Opt-Out" Referral: Implementing a referral system where patients are automatically scheduled for a consultation at the NDC unless they actively decline. This approach normalizes smoking cessation as part of routine care.
Reinforcement: Reinforcing the importance of the referral through multiple personnel, including surgeons and surgical nurse educators.
Streamlined Processes: Updating electronic medical records with documentation templates and order sets to facilitate easy referral.

The intervention emphasized an "opt-out" approach, framing tobacco treatment as an essential component of cancer care. This proactive method aimed to reach a broader range of smokers, regardless of their immediate readiness to quit. To facilitate this, the team developed a clear protocol and provided resources and training to all relevant staff members.

The Path Forward: Embedding Tobacco Dependence Treatment in Cancer Care

The findings of this study strongly suggest that similar referral interventions should be implemented for all cancer patients. By seamlessly integrating tobacco dependence treatment into the cancer treatment plan, healthcare providers can significantly improve patient outcomes and overall well-being.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s00520-018-4486-5, Alternate LINK

Title: Design, Implementation, And Evaluation Of An Intervention To Improve Referral To Smoking Cessation Services In Breast Cancer Patients

Subject: Oncology

Journal: Supportive Care in Cancer

Publisher: Springer Science and Business Media LLC

Authors: Margaret Nolan, Jennifer L. Ridgeway, Karthik Ghosh, David Martin, David O. Warner

Published: 2018-10-03

Everything You Need To Know

What is the primary goal of the intervention?

The core focus is on improving patient outcomes for breast cancer patients by helping them quit smoking. It highlights how integrating smoking cessation support into standard cancer treatment can be significantly improved. By streamlining referral processes to services like the Nicotine Dependence Center (NDC), more patients receive the help they need. This ultimately leads to better health and recovery prospects, particularly for those undergoing breast reconstruction. The intervention focused on a structured approach to encourage smoking cessation as a key part of their care.

What were the key components of the intervention implemented in this study?

The intervention involved several key elements. First, it ensured consistent documentation of a patient's smoking status at every stage of their care. Secondly, healthcare providers, including physicians and nurse practitioners, were educated on the benefits of quitting and how to discuss them with patients. A crucial part of the intervention was the 'opt-out' referral system. Patients were automatically scheduled for a consultation at the Nicotine Dependence Center (NDC) unless they specifically declined. The intervention also included reinforcement from multiple personnel, like surgeons and nurse educators, and streamlined processes within the electronic medical records to facilitate easy referrals. These combined efforts aimed to make tobacco treatment a standard and proactive part of breast cancer care.

Why is the 'opt-out' referral system so important?

The 'opt-out' referral system, a central component of the intervention, is significant because it normalizes smoking cessation as a routine part of cancer care. Instead of requiring patients to take the initiative to seek help, they are automatically offered support through the Nicotine Dependence Center (NDC). This proactive approach is designed to reach a broader range of smokers, including those who might not have actively sought out help on their own. This strategy ensures that more patients are exposed to tobacco treatment services, which is crucial for improving health outcomes. The goal is to make the referral process as seamless and accessible as possible, thereby increasing the likelihood that patients will receive and benefit from these services.

What is the significance of the Nicotine Dependence Center (NDC)?

The Nicotine Dependence Center (NDC) is a key resource mentioned for providing tobacco treatment services. The intervention aimed to increase referrals to the NDC to ensure that patients have access to professional support and resources for quitting smoking. The NDC likely offers various services, such as counseling, medication, and other evidence-based treatments, to help patients successfully quit smoking. By integrating referrals to the NDC into the breast cancer care plan, the intervention ensures that patients receive comprehensive support tailored to their needs, thereby increasing their chances of achieving long-term smoking cessation and improving their health outcomes.

What is the broader implication of the study's findings?

The study underscores the importance of implementing similar referral interventions for all cancer patients. By systematically incorporating tobacco dependence treatment into the overall cancer treatment plan, healthcare providers can significantly improve patient outcomes and overall well-being. This involves consistent documentation of smoking status, educating providers, using 'opt-out' referral systems to resources like the Nicotine Dependence Center (NDC), reinforcing referrals from multiple sources, and streamlining processes within electronic medical records. The ultimate goal is to make smoking cessation an integral and proactive component of cancer care, leading to improved health outcomes and quality of life for patients.