Appendix 1: IASLC Survey

1. What is your terminal degree or primary professional degree?

  1. Medical degree
  2. Basic science degree
  3. Higher science degree
  4. Nursing degree/diploma
  5. Pharmacy degree/diploma
  6. Allied professional diploma in respiratory science/radiation technology, etc
  7. Other (specify)

2. If you are directly involved with patients, what is your primary area of clinical practice?

A. Surgical Oncology (any surgical specialty)

B. Medical Oncology (any medical specialty)

C. Radiation Oncology

D. Pulmonology/Respirology/Pneumonology

E. Diagnostic Radiology

F. Pathology

G. Pharmacy or pharmacology

H. Internal medicine (Hospitalist or Internist)

I. Genetics or molecular medicine

J. Psychology, Psychiatry, Social Work, or Counseling

K. Not Applicable

L. Other (please specify) ______

3. If you are a clinician, how would you describe your primary work setting?

A. University or Academic Center

B. Hospital based non-academic center

C. Stand-alone (non-hospital based) multi-physician practice

D. Stand-alone (non-hospital based) solo practice

E. Other

F. Not Applicable

4. What percentage of your time to you devote to patient care?

A. 0%

B. 1-24%

C. 25-49%

D. 50-74%

E. 75-100%

5. How many years have passed since completion of your most senior degree (i.e. MD, PhD, RN,etc.)?

A. I am still enrolled in a terminal degree program

B. less than 1 year

C. 1-5 years

D. 6-10 years

E. 11-20 years

F. 20+ years

6. Please indicate how frequently you do the following in your interactions with patients on an INITIAL visit.

Not Applicable / Never / Rarely / Some of the time / Most of the time / Always
Ask your patients if they smoke or use tobacco products
Ask people who smoke or use tobacco if they will quit tobacco use
Advise people who smoke or use tobacco products to stop smoking
Discuss medication options such as nicotine replacement, bupropion, varenicline, etc.
Actively treat or refer patients for smoking/tobacco use cessation intervention

7. During FOLLOW-UP appointments for patient who have a history of tobacco use, how often do you:

Not Applicable / Never / Rarely / Some of the time / Most of the time / Always
Ask patients about current smoking or tobacco use
Ask patients if they have quit smoking or stopped using tobacco
Ask patients if they have relapsed back into tobacco use
Reinforce the importance of stopping tobacco use

8. What do you feel are BARRIERS to providing tobacco cessation interventions in cancer patients who currently smoke or use tobacco?

Strongly Agree / Agree / No opinion or Neutral / Disagree / Strongly Disagree
Inability to get patients to quit tobacco use
Waste of time – cessation does not affect outcomes in cancer patients
Lack of time for counseling or to set up a referral
No or limited provider reimbursement
Patient resistance to cessation treatment
Lack of training or experience in tobacco cessation interventions
Lack of available resources or referrals for cessation interventions

9. Please provide your opinion/judgment for the following statements.

Strongly Agree / Agree / No opinion or Neutral / Disagree / Strongly Disagree
Current smoking or tobacco use impacts treatment outcomes in cancer patients
Tobacco cessation should be a standard part of cancer treatment interventions
I have had adequate training in tobacco cessation interventions
Clinicians need more training in tobacco assessment and cessation interventions
I believe tobacco smoking is the primary cause of the current lung cancer burden

10. Have you smoked at least 100 cigarettes or used other tobacco products in your life?

A. Yes

B. No

C. Don’t know

11. Do you now smoke cigarettes or use other tobacco products every day, some days, or not at all?

A. Every day

B. Some days

C. Not at all

D. not willing to answer

12. In what country do you primarily practice? ______