Predictors of Patient Engagement in Telehealth-Delivered Tobacco Cessation Treatment during the COVID-19 Pandemic

• Published in: International journal of environmental research and public health Vol. 21; no. 2; p. 131
• Main Authors: Jagielo, Annemarie D, Chieng, Amy, Tran, Cindy, Pirkl, Amy, Cao-Nasalga, Ann, Bragg, Ashley, Mirkin, Rachelle, Prochaska, Judith J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 25.01.2024
• Subjects: Cancer; Coronaviruses; Counseling; COVID-19; COVID-19 - epidemiology; Electronic health records; Ethnicity; Female; Health disparities; Health risk assessment; Health risks; Hispanic Americans; Humans; Male; Medical diagnosis; Middle Aged; Oncology; Pandemics; Patient Participation; Patients; Psychologists; Quality improvement; Regression analysis; Smoking Cessation; Sustainability; Telemedicine; Tobacco; Tobacco Use Cessation; COVID-19; cancer care; tobacco treatment; smoking cessation; quality improvement; pandemic; oncology
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph21020131

Smoking causes one in three cancer deaths and may worsen COVID-19 outcomes. Telehealth tobacco cessation treatment is offered as a covered benefit for patients at the Stanford Cancer Center. We examined predictors of engagement during the COVID-19 pandemic. Data were abstracted from the Electronic Health Record between 3/17/20 (start of pandemic shelter-in-place) and 9/20/22, including patient tobacco use, demographics, and engagement in cessation treatment. Importance of quitting tobacco was obtained for a subset (53%). During the first 2.5 years of the pandemic, 2595 patients were identified as recently using tobacco, and 1571 patients were contacted (61%). Of the 1313 patients still using tobacco (40% women, mean age 59, 66% White, 13% Hispanic), 448 (34%) enrolled in treatment. Patient engagement was greater in pandemic year 1 (42%) than in year 2 (28%) and year 3 (19%). Women (41%) engaged more than men (30%). Patients aged 36-45 (39%), 46-55 (43%), 56-65 (37%), and 66-75 (33%) engaged more than patients aged 18-35 (18%) and >75 (21%). Hispanic/Latinx patients (42%) engaged more than non-Hispanic/Latinx patients (33%). Engagement was not statistically significantly related to patient race. Perceived importance of quitting tobacco was significantly lower in pandemic year 1 than year 2 or 3. Nearly one in three cancer patients engaged in telehealth cessation treatment during the COVID-19 pandemic. Engagement was greater earlier in the pandemic, among women, Hispanic/Latinx individuals, and patients aged 36 to 75. Sheltering-in-place, rather than greater perceived risk, may have facilitated patient engagement in tobacco cessation treatment.