In a randomised trial published in the Journal of Clinical Oncology, 306 adults recently diagnosed with cancer who smoked were studied across 37 community oncology sites, and a virtual tobacco program with sustained telehealth counselling plus free nicotine replacement therapy nearly doubled 6-month quit rates vs quitline referral alone (28.4% vs 14.7%). For NPs and PAs on the front line, this is a clear closure point: proactive, repeated follow-up—not a handoff—helped more patients quit during active cancer care.

Why It Matters To Your Practice

• NPs and PAs often spot ongoing tobacco use first, and this study reinforces that your intervention is not secondary—it is pivotal to cancer outcomes and treatment readiness.

• Patients in community oncology settings engaged with virtual care at high rates, with more than 80% participating in telehealth counselling.

• This model fits real-world workflows: sustained outreach, medication access, and follow-up can be integrated into routine oncology care without waiting for a physician-only touchpoint.

Clinical Benefits

• The intervention improved 7-day point-prevalence abstinence at 6 months: 28.4% vs 14.7% with enhanced usual care.

• Patients who completed more than 8 counselling sessions were significantly more likely to quit than those attending fewer than 5, underscoring the value of longitudinal NP/PA-led reinforcement.

• The program also increased guideline-concordant smoking cessation medication use and improved continuous abstinence and smoking reduction rates.

Managing Risks

• A quitline referral alone may underperform for patients newly diagnosed with cancer, who often need more proactive and sustained support.

• Watch for drop-off in counselling attendance; the dose-response signal suggests fewer sessions may mean lower quit success.

• Build workflows for medication access, follow-up scheduling, and symptom-sensitive counselling during treatment to reduce missed opportunities.

The Bottom Line

• For patients with cancer who smoke, sustained telehealth treatment plus free nicotine replacement therapy outperformed referral alone.

• NPs and PAs are ideally positioned to drive this care: you are the clinicians who can identify tobacco use, initiate evidence-based treatment, and keep patients engaged across the cancer journey.

• If your oncology service wants a practical quality win, this is one with measurable impact on cessation during active treatment.