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J Am Coll Radiol. 2020 Jan 10. pii: S1546-1440(19)31450-4. doi: 10.1016/j.jacr.2019.12.008. [Epub ahead of print]

Screening Mammography Visits as Opportunities to Engage Smokers With Tobacco Cessation Services and Lung Cancer Screening.

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Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts. Electronic address:
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Department of Psychiatry, Mongan Institute Health Policy Research Center, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts.
Center for Community Health Improvement, Massachusetts General Hospital, Boston, Massachusetts.



Tobacco use is the leading cause of preventable mortality in the United States. Screening mammography (SM) visits present opportunities for radiology practices to reduce tobacco-related morbidity and mortality. Our study evaluates implementation of a program that provides tobacco cessation service referrals and screens for lung cancer screening (LCS) eligibility among smokers presenting for SM at a community health center.


In 2018, two sets of questions were added to our SM patient intake questionnaire to assess (1) smoking history and (2) interest in referral to the health center-based tobacco cessation program for mailed information, telephone-based consultation, and in-person counseling. Primary outcomes were proportion of current smokers who requested a referral and of all smokers who were LCS-eligible. Bivariate logistic regression analyses compared sociodemographic characteristics of smokers who requested versus declined a referral.


Of the 89.3% (1,907 of 2,136) who responded, 10.5% (201 of 1,907) were current and 29.1% (555 of 1,907) were former smokers. Of current smokers, 26.4% (53 of 201) requested referrals: mailed information by 23.9% (48 of 201), in-person counseling by 9% (18 of 201), and telephone-based consultation by 7.5% (15 of 201). No sociodemographic predictors for referral requests were identified. Of all smokers, 9.3% (70 of 756) were eligible for LCS, of which 31.4% (22 of 70) were up to date.


One in ten women who underwent SM at our community health center were current smokers, of which one-quarter requested tobacco cessation referrals. Among LCS-eligible smokers, one-third were up to date. SM presents opportunities for radiology practices to advance population health goals such as tobacco cessation and LCS.


Lung cancer screening; population health; screening mammography; tobacco cessation


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