Alain Tremblay1, Niloofar Taghizadeh2, Jane Huang3, Debra Kasowski3, Paul MacEachern2, Paul Burrowes4, Andrew J Graham5, James A Dickinson6, Stephen C Lam7, Huiming Yang8, Rommy Koetzler2, Martin Tammemagi9, Kathryn Taylor10, Eric L R Bédard11. 1. Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: alain.tremblay@ucalgary.ca. 2. Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 3. AlbertaQuits Helpline, Health Links - Alberta Health Services, Edmonton, Alberta, Canada. 4. Department of Diagnostic Imaging, Foothills Medical Center, Alberta Health Services, Calgary, Alberta, Canada. 5. Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 6. Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 7. Department of Integrative Oncology, The British Columbia Cancer Research Center, Vancouver, British Columbia, Canada. 8. Population, Public and Indigenous Health, Alberta Health Services, Calgary, Alberta, Canada. 9. Department of Medical Sciences, Brock University, St. Catharines, Ontario, Canada. 10. Department of Oncology, Georgetown University Medical Center, Washington, DC. 11. Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Abstract
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 = 171) or control arm (n = 174). Thirty-day smoking abstinence at 12 months post-randomization 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 = 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 older long-term smokers to determine the optimal method of integrating smoking cessation with lung cancer screening (clinicaltrials.govNCT02431962).
RCT Entities:
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 = 171) or control arm (n = 174). Thirty-day smoking abstinence at 12 months post-randomization 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 = 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 older long-term smokers to determine the optimal method of integrating smoking cessation with lung cancer screening (clinicaltrials.govNCT02431962).
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