Hollings researcher helps to develop national smoking cessation study in cancer care settings

One in every three cancer deaths in the U.S. is linked to smoking. Tobacco use is also associated with 12 different types of cancer. The statistics are staggering and unmistakable. It’s why Graham Warren, M.D., Ph.D., is so excited about a national smoking cessation study he helped to develop for cancer care centers across the country.

Warren is a radiation oncologist at MUSC Hollings Cancer Center, the Mary Gilbreth Endowed Chair of Oncology and the vice chairman for research in the MUSC Department of Radiation Oncology. He’s also a world-renowned doctor and researcher in the growing field of looking at the correlation between tobacco use and cancer treatment outcomes.

“Smoking by cancer patients and survivors increases the risk for cancer recurrence and death,” Warren said. “Quitting smoking, even after a cancer diagnosis, can make a difference and is associated with improved survival.”

Warren worked with the American College of Surgeons’ Commission on Cancer (CoC) to develop a new program that can increase smoking cessation efforts and research in 1,500 national cancer centers. The project, titled “Just ASK,” requires cancer center staff to ask new cancer patients if they smoke and encourages them to help their patients to quit smoking.

“This is an outstanding advance in spreading the word about the harms of smoking after a diagnosis and educating patients about the need to quit smoking.”
— Dr. Graham Warren

Warren said the quality-improvement project is the first step in addressing smoking by cancer patients and strengthening access to evidence-based smoking cessation care for cancer patients across multiple cancer care settings in the U.S.

“This is an outstanding advance in spreading the word about the harms of smoking after a diagnosis and educating patients about the need to quit smoking,” Warren said. “We have made tremendous advances at the institutional, state and national levels, including developing smoking cessation programs across 52 NCI-designated cancer centers through the NCI Cancer Centers Cessation Initiative (C3I) and across Canada with the Canadian Partnership Against Cancer (CPAC). But our work isn’t done yet, since most patients receive their cancer care in community oncology clinics.”

Improving smoking cessation efforts in cancer settings isn’t a new task for Warren. He worked with others to develop the smoking cessation program at Roswell Park Cancer Institute in 2010, across community cancer centers in Michigan with state quit lines and at Hollings since 2013, which has now grown to provide services to inpatients and outpatients across MUSC Health and support several grants by MUSC investigators. Since 2015, he has worked with CPAC to increase the number of smoking cessation services being offered at cancer care settings in Canada from 26% to 87%, and efforts with C3I have supported over 63,000 cancer patients since 2018.

Warren is hopeful that Just ASK can be the beginning of a similar expansion of smoking cessation services across U.S. cancer centers. “The Commission on Cancer is an ideal group to expand these efforts across most cancer centers in the United States, including community cancer centers. It is humbling to think of how many patients could be impacted by this effort.”

Warren said the tobacco treatment efforts and program at Hollings, led by Benjamin Toll, Ph.D., and Mike Cummings, Ph.D., are excellent examples for other CoC sites, emphasizing why smoking cessation efforts for cancer patients are so important.

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