Summary
Professor Fitzpatrick’s research findings impact all patients with cancer who smoke. Patients with cancer who smoke (up to 20% of all diagnosed) are not currently offered support to quit, despite evidence of the benefits of quitting after a cancer diagnosis. These benefits include improved treatment outcomes, fewer treatment complications, improved survival rates and positive effects on health. The impacts of Professor Fitzpatrick’s research are national and international; the research was adopted in full by the HSE National Cancer Control Programme and is a priority for 2024.
3,744 - 4,959 patients with cancer, and their families, will benefit each year. The research was reported in national media and a podcast on the research has been released by the European School of Oncology. The research team have published widely in academic and professional healthcare publications.
Research description
The benefits of quitting smoking after a cancer diagnosis are undervalued, despite substantial evidence. Continued smoking is associated with treatment complications and toxicities in the body, increased risk of recurrence, new smoking-related cancers of another type, lower survival and diminished quality of life. But many diagnosed with cancer continue smoking and do not receive support to help them stop.
This Irish Cancer Society-funded research was co-developed with cancer patients who smoke to develop a way to help them cease smoking. The project comprised a number of stages. At the outset of the project, Professor Fitzpatrick participated in a Patient Voice in Cancer Research Dragon’s Den event to present the study plan and seek input. The research team then established a steering committee and invited people with lived experience, academics and practice experts to take part. The research team published a rapid systematic review examining relevant practices to help patients stop smoking and analysed smoking rates among cancer patients using a national hospital discharge database (2014-2018). As well as this, Professor Fitzpatrick audited all 8 adult specialist cancer hospitals and the major radiotherapy centre against national clinical guidelines. The team completed interviews with patients attending four cancer hospitals and oncology healthcare professionals and the results were discussed at a Patient Voice in Cancer Research workshop.
The rapid systematic review identified discrepancies in interventions designed to help smokers with a cancer diagnosis to quit. It identified a lack of trained professionals who could provide this support; a similar lack of hospital smoking cessation officers and referral practices to smoking cessation services were also noted in the audit. The team found that although there has been a drop in smoking rates amongst the general population, smoking rates in patients with cancer have not fallen in line with this. Qualitative analysis of patient interviews found a willingness to be repeatedly approached and supported to quit, and it outlined the need for sustained, non-judgemental support across hospital and community settings and the importance of healthcare practitioners and family as facilitators of the process of quitting. Interviews with healthcare professionals identified the importance of prioritising the therapeutic relationship with patients while maintaining a willingness from them to discuss quitting. However, they also outlined challenges in starting the conversation given heavy workloads and a lack of knowledge around the relevant support services available.
