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Lung Cancer. 2017 Jun;108:242-246. doi: 10.1016/j.lungcan.2017.01.020. Epub 2017 Feb 15.

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

Author information

1
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States. Electronic address: TAYLORKL@georgetown.edu.
2
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
3
Department of Biostatistics, Bioinformatics, and Biomathematics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
4
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States; Behavioral Health Group, Westat, Inc., Rockville, MD, United States.
5
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States; The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC, United States.
6
Medstar Georgetown University Hospital, Washington, DC, United States.
7
Sophia Gordon Cancer Center, Lahey Hospital and Medical Center, Burlington, MA, United States.
8
John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, United States.

Abstract

Incorporating effective smoking cessation interventions into lung cancer screening (LCS) programs will be essential to realizing the full benefit of screening. We conducted a pilot randomized trial to determine the feasibility and efficacy of a telephone-counseling (TC) smoking cessation intervention vs. usual care (UC) in the LCS setting. In collaboration with 3 geographically diverse LCS programs, we enrolled current smokers (61.5% participation rate) who were: registered to undergo LCS, 50-77 years old, and had a 20+ pack-year smoking history. Eligibility was not based on readiness to quit. Participants completed pre-LCS (T0) and post-LCS (T1) telephone assessments, were randomized to TC (N=46) vs. UC (N=46), and completed a final 3-month telephone assessment (T2). Both study arms received a list of evidence-based cessation resources. TC participants also received up to 6 brief counseling calls with a trained cessation counselor. Counseling calls incorporated motivational interviewing and utilized the screening result as a motivator for quitting. The outcome was biochemically verified 7-day point prevalence cessation at 3-months post-randomization. Participants (56.5% female) were 60.2 (SD=5.4) years old and reported 47.1 (SD=22.2) pack years; 30% were ready to stop smoking in the next 30 days. TC participants completed an average of 4.4 (SD=2.3) sessions. Using intent-to-treat analyses, biochemically verified quit rates were 17.4% (TC) vs. 4.3% (UC), p<.05. This study provides preliminary evidence that telephone-based cessation counseling is feasible and efficacious in the LCS setting. As millions of current smokers are now eligible for lung cancer screening, this setting represents an important opportunity to exert a large public health impact on cessation among smokers who are at very high risk for multiple tobacco-related diseases. If this evidence-based, brief, and scalable intervention is replicated, TC could help to improve the overall cost-effectiveness of LCS.

TRIAL REGISTRATION:

NCT02267096, https://clinicaltrials.gov.

KEYWORDS:

Lung cancer screening; Randomized trial; Smoking cessation; Telephone counseling

PMID:
28216065
PMCID:
PMC5476481
DOI:
10.1016/j.lungcan.2017.01.020
[Indexed for MEDLINE]
Free PMC Article

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