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Smoking Cessation Methodology

Smoking Cessation: Reported Tobacco Screening
Short description of Indicator Percentage of new ambulatory cancer cases that were screened for tobacco use.
Rationale for measurement Smoking cessation has been shown to improve cancer prognosis, through greater response to treatment, less toxicity from radiation therapy and better post-surgical wound healing. In addition, quitting smoking may decrease the possibility of cancer returning following treatment, or the development of a second primary cancer. To ensure the delivery of quality cancer care, screening new ambulatory cancer patients for tobacco use allows cancer centres to identify and support cancer pateints to quit smoking tobacco. The tobacco screening measurement indicates smoking cessation activity in regional cancer centres across Ontario over time.
Evidence/references for rationale
  • Cancer Care Ontario. Ontario Cancer Plan IV: 2016-2019. Toronto, Canada, 2016.
  • Cancer Care Ontario. Ontario Cancer Plan III: 2011-2015. Toronto, Canada, 2011.
  • U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.
Calculations for the indicator

Tobacco screening rate

((Screened for tobacco use) ÷ (Total number of new ambulatory cancer cases)) x 100

Standardized Rate Calculation N/A
Unit Percentage (%)​
Data sources Data Holding Area (Production environment)
Time Frame January 2016 to December 2018
Geographic Scale Provincial
Denominator description ​The denominator for tobacco screening (Total number of new ambulatory cancer cases) is calculated by the Smoking Cessation project team using the Disease, and Clinic Visit entities in ALR Data Holding Area.
Numerator description The numerator for tobacco screening (screened for tobacco use) is calculated from the Smoking Cessation entity where data from the regional cancer centres is gathered and housed by Informatics.
Considerations  This data undergoes general quality assurance checks by the Informatics team as outlined in the Master List of QA Checks in the online Data Book guide. Both the numerator and denominator are subject to further restrictions as determined through consultation between CCO, the Smoking Cessation Advisory Committee and the regional cancer centre smoking cessation champions. The data is limited to cases that have a confirmed cancer or benign diagnosis (ICD C000–D489). Additional primaries for the same patient within 12 months of the initial primary and tobacco screening that occurred more than 60 days after the patients’ first visit to the cancer centre were excluded from our analysis. Tobacco screening that occurred at a non-regional cancer centre site (satellite site), and clinic visits flagged as inpatient visits were also excluded.
Data availability & limitations The data available is representative of smoking cessation activities that regional cancer centre staff document and their information technology team is able to submit through activity level reporting. Data collection and submission may be affected by issues in staff training, compliance with recording smoking cessation activity or information technology limitations at specific regional cancer centres.