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Researchers report mixed sustainment of tobacco cessation programs at NCI cancer centers after C3I funding ends
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Summary
An R01 study of the Cancer Center Cessation Initiative (C3I) finds many sites continue tobacco treatment services but key functions such as outcomes reporting and training decline after funding ends; 47 sites responded (90% response), 83% reported ongoing services, and over one-third said $50,000 or less could optimize programs.
Dr. Ramsey Saloon presented early results from an R01 evaluating sustainability of tobacco cessation programs implemented through the Cancer Center Cessation Initiative (C3I), a 2017 NCI Cancer Moonshot effort that funded 52 NCI‑designated cancer centers.
Saloon said that C3I — coordinated by the University of Wisconsin — reached more than 100,000 patients and that survey and evaluation data show evidence of program effectiveness: “more than 20 percent of patients receiving tobacco treatment, reporting that they have quit using tobacco at 6 months.” His R01 uses historical coordinating‑center data and new data collection and achieved a 90% response rate to a recent survey (47 sites).
Among responding sites, 83% reported they still operate tobacco treatment services. Saloon reported variable maintenance of core program functions: screening was the most durable function while referral, measurement of reach and effectiveness, outcomes reporting, education and training declined after funding ended. He described use of the Clinical Sustainability Assessment Tool (CSAT) and Program Sustainability Assessment Tool (PSAT), noting that added domains such as funding stability and strategic planning scored lower than many CSAT domains.
On financing, Saloon said about 40% of sites reported peak budgets between $100,000 and $250,000; 70% of sites maintained those budgets while 30% experienced decreases. When asked how much additional funding was needed to optimize programs, “over one third said that they only needed $50,000 or less.” Institutional support was the dominant funding source, with operating sites more likely to supplement with billing/reimbursement, philanthropy or grants.
Saloon and other panelists emphasized design choices that support sustainment, including creating low‑maintenance reporting systems and, in the absence of mandates, encouraging funders to consider reporting requirements to improve long‑term monitoring. His team is conducting interviews to understand determinants of sustainment, plan to evaluate whether adaptations were planned or unplanned, and will map implementation strategies to sustainment outcomes.
