Tobacco-Related Practice and Oncology Social Workers: An Exploratory Study

Background: Tobacco use, particularly cigarette smoking, causes approximately 430,000 deaths annually in the United States and is considered to be the number one preventable cause of death. Nearly one-third of all cancers are due to tobacco use; therefore, it is likely that many cancer patients and survivors smoke. While a tobacco-related illness, particularly cancer, may be a motivating factor to help some smokers quit, approximately one-third of smokers continue to smoke after a cancer diagnosis. The major aim of this study was to increase the understanding of the knowledge, attitudes, education/training, workplace factors, self-perceived competence and practices of oncology social workers as they relate to tobacco and smoking cessation. Methods: This study utilized a cross-sectional design to study the tobacco-related knowledge, attitudes, education/training, workplace factors, self-perceived competence (self-efficacy), and practice of oncology social workers. A self-administered, Internet-based survey was sent to members of the Association of Oncology Social Work; the final response rate was 12%. Results: Five of the eight independent variables were significantly (p<.01) correlated with tobacco-related oncology social work practice (dependent variable). These include tobacco-related knowledge (r=.349); continuing educational units (training) (r=.339); workplace facilitators (r=.554); tobacco-related attitudes (r=.343); and self-perceived competence (r=.642). A multiple regression model was developed to predict tobacco-related oncology social work practice. Only one variable, self-perceived competence, remained significant in the final model (B=0.891, p<.001). The overall variance accounted for (R2) in the model was .554. Perceived self-competence was found to mediate the relationship between workplace facilitators and tobacco-related oncology social work practice (Sobel test statistic=3.70; p<.0001). Conclusions: Findings from this study indicate that the strongest predictors of tobacco-related oncology social work practice among oncology social workers are workplace facilitators and self-perceived competence. The fact that workplace facilitators are a key component of practice, additional support of oncology social workers in the workplace may be necessary in order to facilitate additional tobacco-related oncology social work practices. Additionally, finding ways to increase the self-perceived competence of oncology social workers in the area of tobacco may lead to increase tobacco-related practice in this group. Similar research should be conducted with social workers who work with varying populations. In particular, research on social workers in the alcohol and other drugs field may be of particular interest, as addictions such as alcohol and other illicit drugs are related to the addiction of tobacco. Improved understanding about how oncology social workers can increase their self-perceived competence in tobacco-related practices is essential to increasing their activity in this area.