Smoking-cessation expert Dr. Jonathan Bricker has received a $100,000 grant from the CVS Health Foundation — supplemented by a $30,000 grant from Seattle Cancer Care Alliance — to create and implement a digitized screening process to help identify and support cancer patients who want to quit smoking.
The program, tentatively named Electronic Health Assessment and Resources Tool, or eHART, will provide what Bricker called a “21st-century solution” to help identify cancer patients who want to kick the habit: a tablet-based software application, or app, that patients can potentially use in waiting or exam rooms.
The vision of the eHART app is to determine the patient’s smoking status (and other pertinent data), evaluate their interest in kicking the habit and, if so, connect them with a number of evidence-based smoking-cessation options including in-person or telephone counseling; the SmartQuit app developed by Bricker; or anti-smoking medications (think Chantix, Zyban or a nicotine patch). Participating patients would have their progress tracked through electronic medical records so additional help could be offered if needed.
If successful, eHART potentially could be disseminated to cancer centers across the U.S., the public health researcher said. A 2014 study from the American Cancer Society found nearly 10 percent of cancer patients still smoke.
“We are thrilled at the generosity of the CVS Health Foundation and Seattle Cancer Care Alliance in helping us create this program,” said Bricker upon receiving the two grants. “Cancer patients are inconsistently being triaged for smoking cessation. There are a lot of reasons for that — attitudinal barriers, a belief that it doesn’t matter — but this is a way to cut through all of that and make sure everyone gets screened and everyone gets asked how motivated they are to quit. It will give the patients choices. Do they want medication? Counseling? Do they want to get help through an app?
“We want to make the technology be the touchpoint,” he said. “That way, clinicians who may not have time to do it, don’t have to do it. The technology does it for them.”
Katie Brown, associate director of SCCA’s clinical operations, termed the eHART project an outstanding opportunity to take advantage of Fred Hutch’s leading-edge smoking-cessation research.
“SCCA is privileged to be a place where Dr. Bricker and his world-class team can explore their questions and learn from SCCA’s dynamic patient population,” she said. “This pilot represents the beginning of a longer relationship with Dr. Bricker and his team to continue developing SCCA’s tobacco-cessation services. It’s an incredible opportunity for the future of the program and for our patients and their families because we can fully integrate research into our clinical program. We’re optimistic that, together, our reach will extend beyond this region to improve tobacco-cessation programs at cancer centers across the country.”
CVS Health has been a staunch proponent for tobacco-free lives for several years. In 2014, the company became the first and remains the only national pharmacy to quit selling tobacco products. Today, it offers its customers a variety of tools to help with smoking/tobacco cessation; and last spring launched a five-year $50 million initiative, Be The First, which is designed to help deliver the nation’s first tobacco-free generation. Through it, the organization partners with a number of nonprofit organizations on the front lines of tobacco control, including Campaign for Tobacco-Free Kids, American Academy of Pediatrics and the American Cancer Society.
The $100,000 grant, inspired by the national Cancer Moonshot effort, marks CVS’ first partnership with Fred Hutch.
“Addressing smoking among at-risk populations, including cancer patients, is a priority for us,” said Eileen Howard Boone, president of the CVS Health Foundation. “We’re proud to support Dr. Bricker and the Fred Hutchinson Cancer Research Center as they bring an innovative smoking-cessation offering to lead the improvement of cancer treatment outcomes for patients and bring us one step closer to the first tobacco-free generation.”
The additional $30,000 from Seattle Cancer Care Alliance will complement its current Living Tobacco-Free Services.
Bricker said the program’s goal is to work with all cancer patients, not just those with cancers commonly associated with smoking such as lung and head and neck cancers. He said the new tool will also help to educate cancer patients and others (think spouses, partners, caregivers and even physicians and researchers) about the survival benefits of kicking a smoking habit.
“Some people may think it’s too late, that it won’t make a difference,” he said. “But there’s a lot of literature that shows that if a person goes through cancer treatment and they continue to smoke, they’ll have much worse outcomes. They’ll have a greater likelihood of recurrence, more complications in surgery and in wound healing and their recovery from the treatment will be worse.”
Bricker anticipates it will take about 12 to 14 months to conduct a patient-clinic needs assessment; develop, test and refine a prototype design; then develop and deploy the technology.
He also believes the health-assessment tool eventually can be used to screen for a number of other behaviors that could lead to interventions beneficial to cancer patients.
“We’re going to ask about smoking cessation but we’re also going to ask about other things like exercise and diet and drinking habits and mental health,” he said. “We’re doing this for smoking but the app can be broadened. It can eventually become a one-stop platform for assessing common health behaviors then connecting patients to service.”
— Diane Mapes / Fred Hutch News Service