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，占癌症死亡的30% 并导致每年超过3000亿美元的医疗支出和生产力损失。美国人 印度(AI)成年人的烟草使用率(32%)仍然高于其他任何国家 美国的种族/民族(13%-25%)，经历了与烟草相关的不成比例的发病率和 死亡率。此外，俄克拉荷马州人工智能个体的年龄调整后癌症发病率最高(637% 与其他种族群体相比，死亡率(每100,000人中有255人)和死亡率(每100,000人中有255人死亡)。继续使用烟草 与非吸烟者相比，癌症诊断后会增加继发性癌症的风险和死亡率。 切罗基部落是美国最大的部落，注册成员超过37.8万人， 减少烟草使用是部落的首要任务之一。切诺基国家与印度医疗服务机构合作 (IHS)为其保留区内的人工智能人口提供医疗服务。因为这个系统， 任何非切诺基国家提供的特殊护理转介都必须通过IHS获得批准 购买和转介护理系统，这可能会使肿瘤护理复杂化。此外，目前还不清楚 AI癌症幸存者在肿瘤护理期间或同时是否常规接受戒烟治疗 在切诺基国家卫生系统内接受初级保健。我们的长期目标是减少 切罗基国家癌症幸存者中烟草使用的流行率。我们的研究旨在1)评估烟草 切罗基国家人工智能癌症幸存者的戒烟经历；2)确定目前的戒烟情况 初级保健和肿瘤学环境中的做法，以及提供戒烟的促进者和障碍 对切罗基国家癌症患者的治疗；以及3)制定量身定制的战略，以加强实施 以及切罗基国家癌症幸存者戒烟治疗的覆盖面。这项研究将提供 洞察切罗基人工智能癌症幸存者戒烟的当前做法和需求 国家。该项目将为R01提案提供初步数据，以比较 旨在改善向癌症幸存者提供的戒烟治疗的执行战略。会的 也为今后侧重于其他循证干预措施的执行研究提供了机会 为切诺基民族的癌症幸存者。

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.