BACKGROUND In response to evidence about the health benefits of smoking cessation at time of cancer diagnosis, Ontario Health (Cancer Care Ontario) (OH-CCO) instructed Regional Cancer Centres (RCC) to implement smoking cessation interventions (SCI). RCCs were given flexibility to implement SCIs according to their context but were required to screen new patients for tobacco status, advise patients about the importance of quitting, and refer patients to cessation supports. The purpose of this evaluation was to identify practices that influenced successful implementation across RCCs. METHODS A realist evaluation approach was employed. Realist evaluations examine how underlying processes of an intervention (mechanisms) in specific settings (contexts) interact to produce results (outcomes). A realist evaluation may thus help to generate an understanding of what may or may not work across contexts. RESULTS The RCCs with the highest Tobacco Screening Rates used a centralized system. Regarding the process for advising and referring, three RCCs offered robust smoking cessation training, resulting in advice and referral rates between 80% and 100%. Five RCCs surpassed the target for Accepted Referral Rates; acceptance rates for internal referral were highest overall. CONCLUSION Findings highlight factors that may influence successful SCI implementation.

中文翻译：

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确定复杂癌症环境中戒烟的最佳实施实践

背景 为响应有关癌症诊断时戒烟对健康有益的证据，安大略健康（安大略省癌症护理）（OH-CCO）指示区域癌症中心（RCC）实施戒烟干预（SCI）。RCC 可以根据其情况灵活地实施 SCI，但被要求筛查新患者的烟草状况，建议患者戒烟的重要性，并将患者转介给戒烟支持。本次评估的目的是确定影响跨 RCC 成功实施的做法。方法 采用现实主义的评价方法。现实主义评估检查特定环境（上下文）中干预（机制）的潜在过程如何相互作用以产生结果（结果）。因此，现实主义的评估可能有助于理解在不同情况下哪些可能有效，哪些可能无效。结果 烟草筛查率最高的 RCC 使用集中式系统。关于建议和转介的过程，三个 RCC 提供了强有力的戒烟培训，导致建议和转介率在 80% 到 100% 之间。五个 RCC 超过了接受推荐率的目标；内部转诊的接受率总体上最高。结论 调查结果突出了可能影响 SCI 成功实施的因素。导致建议和转介率在 80% 到 100% 之间。五个 RCC 超过了接受推荐率的目标；内部转诊的接受率总体上最高。结论 调查结果突出了可能影响 SCI 成功实施的因素。导致建议和转介率在 80% 到 100% 之间。五个 RCC 超过了接受推荐率的目标；内部转诊的接受率总体上最高。结论 调查结果突出了可能影响 SCI 成功实施的因素。