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

Annemarie D. Jagielo, Amy Chieng, Cindy Tran, Amy Pirkl, Ann Cao-Nasalga, Ashley Bragg, Rachelle Mirkin and Judith J. Prochaska ()
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Annemarie D. Jagielo: PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA 94304, USA
Amy Chieng: Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA
Cindy Tran: Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA
Amy Pirkl: Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA
Ann Cao-Nasalga: Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA
Ashley Bragg: Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA
Rachelle Mirkin: Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA
Judith J. Prochaska: Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA

IJERPH, 2024, vol. 21, issue 2, 1-12

Abstract: 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.

Keywords: smoking cessation; tobacco treatment; cancer care; quality improvement; COVID-19; pandemic; oncology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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