Preliminary evaluation of a telephone-based smoking cessation intervention in the lung cancer screening setting: A randomized clinical trial

Taylor, Kathryn L.; Hagerman, Charlotte J.; Luta, George; Bellini, Paula; Stanton, Cassandra A.; Abrams, David B.; Kramer, Jenna A.; Anderson, Eric; Regis, Shawn M.; McKee, Andrea B.; McKee, Brady; Niaura, Ray; Harper, Harry; Ramsaier, Michael

doi:10.1016/j.lungcan.2017.01.020

Cited by 48 publications

(67 citation statements)

References 49 publications

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“…Finally, a pilot study recently reported on shortterm (3-month) quit rates in 92 screening participants randomized to a telephone counseling intervention similar to ours versus usual care and noted similar selfreported quit rates (21.7% vs. 19.6%), although biochemically confirmed quit rates were higher (17.4% vs. 4.3%). 36 Attempts at integrating smoking cessation with cervical cancer screening has had mixed success. 16,37,38 The difficulty in showing increased smoking cessation rates in screening programs through the application of interventions otherwise considered effective requires further discussion.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Study of Integrated Smoking Cessation in a Lung Cancer Screening Program

Tremblay

Taghizadeh

Huang

et al. 2019

Journal of Thoracic Oncology

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Introduction: Smoking cessation activities incorporated into lung cancer screening programs have been broadly recommended, but studies to date have not shown increased quit rates associated with cessation programs in this setting. We aimed to determine the effectiveness of smoking cessation counseling in smokers presenting for lung cancer screening. Methods: This study is a randomized control trial of an intensive telephone-based smoking cessation counseling intervention incorporating lung cancer screening results versus usual care (information pamphlet). All active smokers enrolled in the Alberta Lung Cancer Screening Study cohort were randomized on a 1:1 ratio with a primary endpoint of self-reported 30-day abstinence at 12 months. Results: A total of 345 active smokers participating in the screening study were randomized to active smoking cessation counseling (n ¼ 171) or control arm (n ¼ 174). Thirty-day smoking abstinence at 12 months postrandomization was noted in 22 of 174 (12.6%) and 24 of 171 (14.0%) of participants in the control and intervention arms, respectively, a 1.4% difference (95% confidence interval:-5.9 to 8.7, p ¼ 0.7). No statistically significant differences in 7-day or point abstinence were noted, nor were differences at 6 months or 24 months. Conclusions: A telephone-based smoking cessation counseling intervention incorporating lung cancer screening results did not result in increased 12-month cessation rates versus written information alone in unselected smokers undergoing lung cancer screening. Routine referral of all current smokers to counseling-based cessation programs may not improve long-term cessation in this patient cohort. Future studies should specifically focus on this subgroup of

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Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Study of Integrated Smoking Cessation in a Lung Cancer Screening Program

Tremblay

Taghizadeh

Huang

et al. 2019

Journal of Thoracic Oncology

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“…Importantly, the advice was tailored to smoking attitudes and behaviour but not to understanding of and emotional response to screening test results. A telephone counselling intervention which aimed to use lung cancer screening test results to increase risk perceptions was effective at promoting cessation in a pilot randomised trial [ 20 ]. The stated aim of this strategy was to capitalise on the teachable moment of an abnormal result and to counteract the potential for reduced motivation to quit after a result showing no nodules or abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Determinants of motivation to quit in smokers screened for the early detection of lung cancer: a qualitative study

et al. 2018

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BackgroundThe promotion of smoking cessation within lung cancer screening could lead to benefits for smoking-related disease and improve cost-effectiveness of screening. Little is known about how smokers respond to lung cancer screening and how this impacts smoking behaviour. We aimed to understand how lung cancer screening influences individual motivations about smoking, including in those who have stopped smoking since screening.MethodsThirty one long-term smokers aged 51–74 took part in semi-structured interviews about smoking. They had been screened with the EarlyCDT-Lung Test (13 positive result; 18 negative) as part of the Early Cancer Detection Test Lung Cancer Scotland Study. They were purposively sampled for interview based on their self-reported post-screening smoking behaviour. Eleven participants had stopped smoking since screening. Verbatim interview transcripts were analysed using thematic analysis.ResultsTwo key overarching themes were interpretations of screening test results and emotional responses to those interpretations. Participants’ understanding of the risk implied by their test result was often inaccurate, for example a negative result interpreted as an ‘all-clear’ from lung cancer and a positive result as meaning lung cancer would definitely develop. Those interpretations led to emotional responses (fear, shock, worry, relief, indifference) influencing motivations about smoking. Other themes included a wake-up call causing changes in perceived risk of smoking-related disease, a feeling that now is the time to stop smoking and family influences. There was no clear pattern in smoking motivations in those who received positive or negative test results. Of those who had stopped smoking, some cited screening experiences as the sole motivation, some cited screening along with other coinciding factors, and others cited non-screening reasons. Cues to change were experienced at different stages of the screening process. Some participants indicated they underwent screening to try and stop smoking, while others expressed little or no desire to stop.ConclusionsWe observed complex and individualised motivations about smoking following lung cancer screening. To be most effective, smoking cessation support in this context should explore understanding of screening test results and may need to be highly tailored to individual emotional responses to screening.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6211-1) contains supplementary material, which is available to authorized users.

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“…Five studies on smokers undergoing LCS without any formal SC program reported that 22% had stopped smoking two months after screening [117][118][119][120][121][122], 8% had stopped after six months [123], and 14% were found, by biochemical assay, to be non-smokers a year after screening [124,125]. Ten studies reported outcomes of help given to all smokers undergoing screening [126][127][128][129][130][131][132][133][134][135].…”

Section: Interventions To Stop Smokingmentioning

confidence: 99%

“…No differences were found for standard written self-help materials vs. a list of internet SC resources [136], tailored vs. standard written SC information [137], or a brief SC counselling session on the day of screening vs. self-help printed materials and quit-line details [138]. One study testing the efficacy of six telephone-based services delivered by trained counsellors vs. self-help SC resources reported significantly higher biochemically verified 7-day point prevalent quit rates at 3-month follow-up vs. control (17.4% vs. 4.3%) [120]. One small study reported 57% abstinence for more than six months after cognitive-behaviour therapy therapy (CBT) and pharmacotherapy [122]; another study reported 20% biochemically validated continuous abstinence for one year in smokers who received four sessions of CBT-based telephone counselling by a psychologist and 12 weeks of pharmacotherapy with varenicline [119].…”

Section: Interventions To Stop Smokingmentioning

confidence: 99%

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

Veronesi

Baldwin

Henschke

et al. 2020

Cancers

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Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was demonstrated in the National Lung Screening Trial (NLST) to reduce mortality from the disease. European mortality data has recently become available from the Nelson randomised controlled trial, which confirmed lung cancer mortality reductions by 26% in men and 39–61% in women. Recent studies in Europe and the USA also showed positive results in screening workers exposed to asbestos. All European experts attending the “Initiative for European Lung Screening (IELS)”—a large international group of physicians and other experts concerned with lung cancer—agreed that LDCT-LCS should be implemented in Europe. However, the economic impact of LDCT-LCS and guidelines for its effective and safe implementation still need to be formulated. To this purpose, the IELS was asked to prepare recommendations to implement LCS and examine outstanding issues. A subgroup carried out a comprehensive literature review on LDCT-LCS and presented findings at a meeting held in Milan in November 2018. The present recommendations reflect that consensus was reached.

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Preliminary evaluation of a telephone-based smoking cessation intervention in the lung cancer screening setting: A randomized clinical trial

Cited by 48 publications

References 49 publications

A Randomized Controlled Study of Integrated Smoking Cessation in a Lung Cancer Screening Program

A Randomized Controlled Study of Integrated Smoking Cessation in a Lung Cancer Screening Program

Determinants of motivation to quit in smokers screened for the early detection of lung cancer: a qualitative study

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

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