The proposed study plans to adapt and study the implementation and effectiveness of integrating Clinical and Community Effort Against Secondhand smoke Exposure (CEASE) into the thoracic oncology setting using mixed methods.

In particular the study aims to see if participants are asked about their smoking status and what services are offered if someone indicates being a former or current smoker. Findings from this study will help improve a standard of care at this clinic and allow us to understand what type of tobacco treatment services are preferred by patients.

• Adaption of CEASE will entail exit interviews with patients and individual interviews with clinical staff to identify and address facilitators and barriers to the implementation process.
• Effectiveness of CEASE will be measured through questionnaires & biochemical verification of smoking status using a pre-test/post-test study design before (usual care)and after implementation (CEASE)

Inclusion Criteria:

• Age ≥ 18
• Have an actual or potential diagnosis of thoracic malignancy
• Able to read and write in English.
• Current or recent former smoker (defined as having smoked within past 6 months)
• Must have an active telephone number.

Exclusion Criteria:

• Former smoker greater than 6 months.

• Have any of the below conditions needing immediate medical intervention

  • Hypercalcemia causing lethargy and confusion,
  • Acute respiratory distress
  • Dehydration
  • Hypotension