Tobacco Cessation among American Indian Cancer Survivors in Cherokee Nation

摘要 烟草使用是美国发病率和死亡率的主要原因，占癌症死亡人数的30 并导致每年超过3000亿美元的医疗保健支出和生产力损失。美国 印度（AI）成年人的烟草使用率（32%）继续高于其他任何国家 美国的种族/族裔群体（13%-25%），烟草相关发病率不成比例， mortality.此外，俄克拉荷马州的AI个体具有最高的年龄调整癌症发病率（637%）。 与其他种族群体相比，死亡率（每10万人255人）。继续使用烟草 与非烟草使用者相比，在癌症诊断后吸烟会增加继发性癌症的风险和死亡率。 切罗基族是美国最大的部落，有超过378,000名注册成员， 减少烟草使用是部落的首要任务之一。切罗基民族与印度卫生服务 (IHS)为保留区内的人工智能人口提供医疗保健服务。因为这个系统， 任何非由切罗基国家提供的专科护理的转介必须通过IHS获得批准 购买和转诊治疗系统，可能使肿瘤治疗复杂化。此外，尚不清楚 AI癌症幸存者是否在肿瘤治疗期间或治疗期间定期接受戒烟治疗 在切罗基国家卫生系统内接受初级保健。我们的长期目标是减少 切罗基族癌症幸存者吸烟的流行率。我们的研究旨在1）评估烟草 切罗基族AI癌症幸存者的戒烟经历; 2）确定当前的戒烟情况 初级保健和肿瘤学环境中的实践，沿着提供戒烟的促进者和障碍 治疗切罗基民族癌症患者;和3）制定量身定制的战略，以增加执行 以及切罗基族癌症幸存者戒烟治疗的范围。本研究将提供 深入了解切罗基AI癌症幸存者与戒烟相关的当前实践和需求 民族本项目将为R 01提案提供初步数据，以比较 实施战略，旨在改善为癌症幸存者提供的戒烟治疗。它将 还为今后侧重于其他循证干预措施的实施研究提供了机会 为切罗基族的癌症幸存者举办的

Abstract Tobacco use is the leading cause of morbidity and mortality in the US, accounting for 30% of cancer deaths and resulting in more than $300 billion in annual health care expenditures and productivity loss. American Indian (AI) adults continue to have a higher prevalence of tobacco use (32%) compared to any other race/ethnic group (13%-25%) in the US and experience disproportionate rates of tobacco-related morbidity and mortality. In addition, AI individuals in Oklahoma have the highest age-adjusted cancer incidence (637 per 100,000) and mortality (255 per 100,000) rates compared to other racial groups. Continued use of tobacco after a cancer diagnosis increases the risk of secondary cancers and mortality compared to non-tobacco users. Cherokee Nation is the largest tribe in the United States with more than 378,000 enrolled members, and reducing tobacco use is one of the tribe's top priorities. Cherokee Nation works with Indian Health Service (IHS) to provide healthcare services for the AI population within their reservation area. Because of this system, any referral for specialty care not provided by Cherokee Nation must obtain approval through the IHS Purchased and Referred Care system, which may complicate oncology care. Furthermore, it is unclear whether AI cancer survivors routinely receive tobacco cessation treatment during their oncology care or while receiving primary care within the Cherokee Nation Health System. Our long-term goal is to reduce the prevalence of tobacco use among cancer survivors in Cherokee Nation. Our study aims to 1) evaluate tobacco cessation experiences among AI cancer survivors in Cherokee Nation; 2) identify current tobacco cessation practices in primary care and oncology settings, along with facilitators and barriers to delivering cessation treatment to Cherokee Nation cancer patients; and 3) develop tailored strategies to increase implementation and reach of tobacco cessation treatment for cancer survivors in Cherokee Nation. This study will provide insight into current practices and needs related to tobacco cessation for AI cancer survivors in Cherokee Nation. This project will provide preliminary data for an R01 proposal to compare the effectiveness of implementation strategies aimed at improving tobacco cessation treatment provided to cancer survivors. It will also provide opportunities for future implementation research focused on other evidence-based interventions for cancer survivors in Cherokee Nation.