Background
Integrating smoking cessation care into cancer management is a pillar of high-quality care. There are practice guidelines available in the United States, Canada, and Australia supporting cancer services to embed evidence-based interventions into routine practice. However, implementation remains variable with little known about how smoking cessation models are effectively adapted for routine practice.
Objective
To describe the characteristics, adaptations, and operationalization of evidence-based smoking cessation models in oncology settings and identify approaches to the definition, measurement and evaluation of implementation outcomes.
Methods
This mixed-methods systematic review followed JBI methodology. Five databases were searched identifying literature published between January 2010 and August 2025. Included studies reported implementation of evidence-based smoking cessation care models or process enhancements in hospitals and cancer services delivering care to people with cancer. Data sources were treated as complementary, synthesized separately and integrated as a narrative summary.
Results
Thirty-eight studies were included, identifying 34 unique implementation interventions and 38 models of care. Models of care included 3As (n=18), 5As (n=12), and 4As (n=1) brief interventions and eight specialist care models. Nurses were commonly delegated to initiate smoking conversations (10/38) and facilitate referrals (17/38) across all approaches. While implementation interventions varied, education and training programs, and technology enhancements featured prominently. Adaptation was reported for 24 of 34 implementation interventions. Reporting and measurement of implementation outcomes was limited, however where assessed, most outcomes (19/21) reported positive changes in favor of the implementation intervention.
Conclusions
Core characteristics of smoking cessation care in this setting include use of brief intervention models and involving nurses in delivery. Adaptation is crucial for ensuring components are tailored to institutional context. There is modest, but growing use of Implementation Science theory and frameworks to guide the evaluation and reporting of implementation outcomes in this setting.