# Leveraging the National Cancer Institute’s Cancer Center Cessation Initiative (C3I) Program to Evaluate and Transform Smoking Cessation Treatment in Cancer Care

> **NIH NIH R35** · UNIVERSITY OF WISCONSIN-MADISON · 2024 · $886,349

## Abstract

PROJECT SUMMARY/ABSTRACT
Cigarette smoking is both common and undertreated among oncology patients. Although smoking is a leading
cause of cancer and results in worse cancer prognoses, only half of cancer patients who smoke are offered
help in quitting during cancer care, and it is unclear that the help they are offered is effective. This R35
proposal is designed to transform oncology practice so that smoking cessation is an integral part of treatment
for all cancer patients who smoke. Electronic health records (EHRs) have tremendous potential to accelerate
improvements in clinical care by facilitating such treatment delivery. EHR modifications can also increase
discovery by enhancing assessment of smoking treatment reach, costs, equity, and effectiveness both in terms
of helping patients quit and improving cancer outcomes. The Principal Investigator has 30 years of experience
leading research and policy efforts to promote the treatment of smoking. Over the past 7 years, he has led a
team that developed and evaluated new EHR-based tools and workflows that markedly increase the proportion
of adult patients who receive evidence-based smoking cessation treatment in primary care. The new R35
proposal will similarly identify intervention strategies that increase smoking treatment engagement and
effectiveness when implemented in oncologic care. Over the last 4 years, the Principal Investigator has served
as Senior Scientist for NCI’s Moonshot-supported Cancer Center Cessation Initiative (C3I), a nationwide effort
of 52 NCI-designated cancer centers to develop and implement programs to aid their patients who smoke. Yet,
this incredibly important initiative has not been systematically assessed in terms of which EHR-enabled
interventions enhance a smoking program’s reach, patient engagement, implementation, cessation
effectiveness, and benefits. This R35 renewal is designed to do just that by systematically assessing best
practices via EHR data extraction of intervention delivery, healthcare costs, short-term cancer treatment
outcomes overall, and by patient demographics. These EHR data will be supplemented by qualitative analysis
of C3I smoking treatment components, delivery, adaptations, and contexts in a mixed-methods approach.
Higher- and lower-performing smoking treatment programs will be identified and rigorous methods will then be
used to select best practice programs from cessation- and cost-effectiveness perspectives. Further
assessment will identify implementation strategies and contextual factors that may contribute to the
effectiveness of these programs. Best practices from these programs will be implemented in lower-performing
C3I programs, with research team support in adaptation and implementation. Pragmatic implementation guides
and strategies will be used to disseminate best practices to cancer care programs nationwide. Thus, the
proposed project seeks to extend and adapt transformative EHR-facilitated system changes that enhance
smoking ...

## Key facts

- **NIH application ID:** 10902099
- **Project number:** 5R35CA197573-10
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** MICHAEL C FIORE
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $886,349
- **Award type:** 5
- **Project period:** 2015-08-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10902099

## Citation

> US National Institutes of Health, RePORTER application 10902099, Leveraging the National Cancer Institute’s Cancer Center Cessation Initiative (C3I) Program to Evaluate and Transform Smoking Cessation Treatment in Cancer Care (5R35CA197573-10). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10902099. Licensed CC0.

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