Engaging Patients in Smoking Cessation Treatment Within the Lung Cancer Screening Setting: Lessons Learned from an NCI SCALE Trial

Overview

Journal Curr Oncol

Publisher MDPI

Specialty Oncology

Date 2022 Apr 21

PMID 35448154

Authors

Randi M Williams

Ellie Eyestone

Laney Smith

Joanna G Philips

Julia Whealan

Marguerite Webster

Tengfei Li

George Luta

Kathryn L Taylor

The Lung Screening Tobacco Health Trial

Affiliations

Soon will be listed here.

Abstract

Offering smoking cessation treatment at lung cancer screening (LCS) will maximize mortality reduction associated with screening, but predictors of treatment engagement are not well understood. We examined participant characteristics of engagement in an NCI SCALE cessation trial. Eligible LCS patients (N = 818) were randomized to the Intensive arm (8 phone counseling sessions +8 weeks of nicotine replacement therapy (NRT)) vs. Minimal arm (3 sessions + 2 weeks of NRT). Engagement was measured by number of sessions completed (none, some, or all) and NRT mailed (none vs. any) in each arm. In the Intensive arm, those with ≥some college (OR = 2.1, 95% CI = 1.1, 4.0) and undergoing an annual scan (OR = 2.1, 95% CI = 1.1, 4.2) engaged in some counseling vs. none. Individuals with higher nicotine dependence were more likely (OR = 2.8, 95% CI = 1.3, 6.2) to request NRT. In the Minimal arm, those with higher education (OR = 2.1, 95% CI = 1.1, 3.9) and undergoing an annual scan (OR = 2.0, 95% CI = 1.04, 3.8) completed some sessions vs. none. Requesting NRT was associated with more pack-years (OR = 1.9, 95% CI = 1.1, 3.5). Regardless of treatment intensity, additional strategies are needed to engage those with lower education, less intensive smoking histories, and undergoing a first scan. These efforts will be important given the broader 2021 LCS guidelines.

Citing Articles

Association of individual and neighborhood socioeconomic status with outcomes of a smoking cessation intervention provided in the lung cancer screening setting.

Avila J, Flores E, Su Y, Haas J, Park E, Rigotti N Prev Med. 2024; 191:108207.

PMID: 39694102 PMC: 11776097. DOI: 10.1016/j.ypmed.2024.108207.

References

Marshall H, Courtney D, Passmore L, McCaul E, Yang I, Bowman R . Brief Tailored Smoking Cessation Counseling in a Lung Cancer Screening Population is Feasible: A Pilot Randomized Controlled Trial. Nicotine Tob Res. 2016; 18(7):1665-9. DOI: 10.1093/ntr/ntw010. View

Taylor K, Cox L, Zincke N, Mehta L, McGuire C, Gelmann E . Lung cancer screening as a teachable moment for smoking cessation. Lung Cancer. 2007; 56(1):125-34. DOI: 10.1016/j.lungcan.2006.11.015. View

Park E, Chiles C, Cinciripini P, Foley K, Fucito L, Haas J . Impact of the COVID-19 pandemic on telehealth research in cancer prevention and care: A call to sustain telehealth advances. Cancer. 2020; 127(3):334-338. PMC: 7675475. DOI: 10.1002/cncr.33227. View

Hestbech M, Siersma V, Dirksen A, Pedersen J, Brodersen J . Participation bias in a randomised trial of screening for lung cancer. Lung Cancer. 2011; 73(3):325-31. DOI: 10.1016/j.lungcan.2010.12.018. View

Neil J, Marotta C, Gonzalez I, Chang Y, Levy D, Wint A . Integrating tobacco treatment into lung cancer screening practices: Study protocol for the Screen ASSIST randomized clinical trial. Contemp Clin Trials. 2021; 111:106586. PMC: 8874354. DOI: 10.1016/j.cct.2021.106586. View

Kee D, Wisnivesky J, Kale M . Lung Cancer Screening Uptake: Analysis of BRFSS 2018. J Gen Intern Med. 2020; 36(9):2897-2899. PMC: 8390735. DOI: 10.1007/s11606-020-06236-9. View

Biener L, Abrams D . The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991; 10(5):360-5. DOI: 10.1037//0278-6133.10.5.360. View

Meza R, Cao P, Jeon J, Taylor K, Mandelblatt J, Feuer E . Impact of Joint Lung Cancer Screening and Cessation Interventions Under the New Recommendations of the U.S. Preventive Services Task Force. J Thorac Oncol. 2021; 17(1):160-166. PMC: 8692396. DOI: 10.1016/j.jtho.2021.09.011. View

Poghosyan H, Sheldon L, Cooley M . The impact of computed tomography screening for lung cancer on smoking behaviors: a teachable moment?. Cancer Nurs. 2012; 35(6):446-75. DOI: 10.1097/NCC.0b013e3182406297. View

10.

Neil J, Chang Y, Goshe B, Rigotti N, Gonzalez I, Hawari S . A Web-Based Intervention to Increase Smokers' Intentions to Participate in a Cessation Study Offered at the Point of Lung Screening: Factorial Randomized Trial. JMIR Form Res. 2021; 5(6):e28952. PMC: 8280830. DOI: 10.2196/28952. View

11.

Taylor K, Hagerman C, Luta G, Bellini P, Stanton C, Abrams D . Preliminary evaluation of a telephone-based smoking cessation intervention in the lung cancer screening setting: A randomized clinical trial. Lung Cancer. 2017; 108:242-246. PMC: 5476481. DOI: 10.1016/j.lungcan.2017.01.020. View

12.

Fu S, Rothman A, Vock D, Lindgren B, Almirall D, Begnaud A . Program for lung cancer screening and tobacco cessation: Study protocol of a sequential, multiple assignment, randomized trial. Contemp Clin Trials. 2017; 60:86-95. PMC: 5558455. DOI: 10.1016/j.cct.2017.07.002. View

13.

Bahadir A, Iliaz S, Yurt S, Ortakoylu M, Bakan N, Yazar E . Factors affecting dropout in the smoking cessation outpatient clinic. Chron Respir Dis. 2016; 13(2):155-61. PMC: 5734603. DOI: 10.1177/1479972316629953. View

14.

Pineiro B, Simmons V, Palmer A, Correa J, Brandon T . Smoking cessation interventions within the context of Low-Dose Computed Tomography lung cancer screening: A systematic review. Lung Cancer. 2016; 98:91-98. DOI: 10.1016/j.lungcan.2016.05.028. View

15.

Cupertino A, Mahnken J, Richter K, Cox L, Casey G, Resnicow K . Long-term engagement in smoking cessation counseling among rural smokers. J Health Care Poor Underserved. 2007; 18(4 Suppl):39-51. DOI: 10.1353/hpu.2007.0117. View

16.

van den Brand F, Nagelhout G, Reda A, Winkens B, Evers S, Kotz D . Healthcare financing systems for increasing the use of tobacco dependence treatment. Cochrane Database Syst Rev. 2017; 9:CD004305. PMC: 6483741. DOI: 10.1002/14651858.CD004305.pub5. View

17.

Clark M, Cox L, Jett J, Patten C, Schroeder D, Nirelli L . Effectiveness of smoking cessation self-help materials in a lung cancer screening population. Lung Cancer. 2004; 44(1):13-21. DOI: 10.1016/j.lungcan.2003.10.001. View

18.

McBride C, Emmons K, Lipkus I . Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003; 18(2):156-70. DOI: 10.1093/her/18.2.156. View

19.

Cummings K, Fix B, Celestino P, Carlin-Menter S, OConnor R, Hyland A . Reach, efficacy, and cost-effectiveness of free nicotine medication giveaway programs. J Public Health Manag Pract. 2005; 12(1):37-43. DOI: 10.1097/00124784-200601000-00009. View

20.

Abrams D, Orleans C, Niaura R, Goldstein M, Prochaska J, Velicer W . Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: a combined stepped-care and matching model. Ann Behav Med. 1996; 18(4):290-304. DOI: 10.1007/BF02895291. View