Smoking Cessation in the ITALUNG Lung Cancer Screening: What Does “Teachable Moment” Mean?

2019 ◽  
Vol 22 (9) ◽  
pp. 1484-1491 ◽  
Author(s):  
Francesco Pistelli ◽  
Ferruccio Aquilini ◽  
Fabio Falaschi ◽  
Donella Puliti ◽  
Cristina Ocello ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Usual Care ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Smoking Cessation Program ◽  
Control Group ◽  
Teachable Moment ◽  
Maximal Effect

Abstract Background Changes in smoking habits and predictors of smoking cessation were examined in the randomized ITALUNG lung cancer screening trial. Methods In three centers, eligible smokers or ex-smokers (55–69 years, ≥20 pack-years in the last 10 years) were randomized to receive annual invitation for low-dose computed tomography for 4 years or usual care. At invitation, subjects received written information for a free smoking cessation program. Quitting outcome was assessed at year 4. Results Among participants who completed baseline assessments and year 4 screening, higher quitting (20.8% vs. 16.7%, p = .029) and lower relapse (6.41% vs. 7.56%, p = .50) rates were observed in the active screening group as compared to the usual-care control group. Corresponding figures in the intention-to-treat analysis were as follows: 16.04% versus 14.64% (p = .059) and 4.88% versus 6.43% (p = .26). Quitting smoking was significantly associated to male gender, lower pack-years, and having pulmonary nodules at baseline. Center-specific analyses showed a threefold statistically significant higher probability to quit associated with participating in the smoking cessation program. A subsample of smokers of the scan group from one center showed higher quitting rates over 12-month follow-up as compared to matched controls from the general population who underwent the same smoking cessation program. Conclusions Consistently with previous reports, in the ITALUNG trial, screened subjects showed significantly higher quit rates than controls, and higher quit rates were associated with both the presence of pulmonary nodules and participating in a smoking cessation program. Maximal effect on quitting outcome was observed with the participation in the smoking cessation program. Implications Participating in lung cancer screening promotes smoking cessation. An effective “teachable moment” may be achieved when the smoking cessation intervention is structured as integral part of the screening clinical visits and conducted by a dedicated team of health care professionals. Standardized guidelines for smoking cessation interventions in lung cancer screening are needed.

scholarly journals Mobile Low-Dose Computed Tomographic (LDCT) Scanning combined with Remote Reading: a feasible approach to lung cancer screening among rural population

2021 ◽  
Author(s):  
Bojiang Chen ◽  
Jun Shao ◽  
Jinghong Xian ◽  
Pengwei Ren ◽  
Wenxin Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Rural Areas ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Western China ◽  
Control Group ◽  
Local Hospital ◽  
Lung Cancers ◽  
Computed Tomographic

Abstract BackgroundLow-dose computed tomographic (LDCT) screening has been proven to be powerful in detecting lung cancers in early stage. However, it’s hard to carry out in less-developed regions in lacking of facilities and professionals. The feasibility and efficacy of mobile LDCT scanning combined with remote reading by experienced radiologists from superior hospital for lung cancer screening in deprived areas was explored in this study.MethodsA prospective cohort was conducted in rural areas of western China. Residents over 40 years old were invited for lung cancer screening by mobile LDCT scanning combined with remote image reading or local hospital-based LDCT screening. Rates of positive pulmonary nodules and detected lung cancers in the baseline were compared between the two groups.ResultsAmong 8073 candidates with preliminary response, 7251 eligibilities were assigned to the mobile LDCT with remote reading (n = 4527) and local hospital-based LDCT screening (n = 2724) for lung cancer. Basic characteristics of the subjects were almost similar in the two cohorts except that the mean age of participants in mobile group was relatively older than control (61.18 vs. 59.84 years old, P < 0.001). 1778 participants with mobile LDCT scans with remote reading (39.3%) revealed 2570 pulmonary nodules or mass, and 352 subjects in the control group (13.0%) were detected 472 ones (P < 0.001). Proportions of nodules less than 8 mm or subsolid were both more frequent in the mobile LDCT group (83.3% vs. 76.1%, 32.9% vs. 29.8%, respectively; both P < 0.05). In the baseline screening, 26 cases of lung cancer were identified in the mobile LDCT scanning with remote reading cohort, with a lung cancer detection rate of 0.57% (26/4527), which was significantly higher than control (4/2724 = 0.15%, P = 0.006). Moreover, 80.8% (21/26) of lung cancer patients detected by mobile CT with remote reading were in stage I, remarkedly higher than that of 25.0% in control (1/4, P = 0.020).ConclusionMobile LDCT combined with remote reading is probably a potential mode for lung cancer screening in rural areas.Trial registrationNo. of registration trial was ChiCTR-DDD-15007586 (http://www.chictr.org).

scholarly journals Capitalizing on a teachable moment: Development of a targeted self-help smoking cessation intervention for patients receiving lung cancer screening

Lung Cancer ◽  
2019 ◽  
Vol 130 ◽  
pp. 121-127 ◽  
Author(s):  
Lauren R. Meltzer ◽  
Marina Unrod ◽  
Vani N. Simmons ◽  
Karen O. Brandon ◽  
Bárbara Piñeiro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Smoking Cessation Intervention ◽  
Teachable Moment ◽  
Self Help ◽  
Cessation Intervention

scholarly journals Patient–Physician Discussions on Lung Cancer Screening: A Missed Teachable Moment to Promote Smoking Cessation

2018 ◽  
Vol 22 (3) ◽  
pp. 431-439 ◽  
Author(s):  
Hasmeena Kathuria ◽  
Elisa Koppelman ◽  
Belinda Borrelli ◽  
Christopher G Slatore ◽  
Jack A Clark ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Treatment Programs ◽  
Teachable Moment ◽  
Smoking Cessation Counseling ◽  
Tobacco Treatment ◽  
Physician Perspectives ◽  
Promote Smoking Cessation

Abstract Introduction Little is known about whether patients and physicians perceive lung cancer screening (LCS) as a teachable moment to promote smoking cessation or the degree to which physicians in “real world” settings link LCS discussions with smoking cessation counseling. We sought to characterize patient and physician perspectives of discussions about smoking cessation during LCS. Methods We conducted a qualitative study (interviews and focus groups) with 21 physicians and 28 smokers screened in four diverse hospitals. Transcripts were analyzed for characteristics of communication about smoking cessation and LCS, the perceived effect on motivation to quit smoking, the degree to which physicians leverage LCS as a teachable moment to promote smoking cessation, and suggestions to improve patient–physician communication about smoking cessation in the context of LCS. Results Patients reported that LCS made them more cognizant of the health consequences of smoking, priming them for a teachable moment. While physicians and patients both acknowledged that smoking cessation counseling was frequent, they described little connection between their discussions regarding LCS and smoking cessation counseling. Physicians identified several barriers to integrating discussions on smoking cessation and LCS. They volunteered communication strategies by which LCS could be leveraged to promote smoking cessation. Conclusions LCS highlights the harms of smoking to patients who are chronic, heavy smokers and thus may serve as a teachable moment for promoting smoking cessation. However, this opportunity is typically missed in clinical practice. Implications LCS highlights the harms of smoking to heavily addicted smokers. Yet both physicians and patients reported little connection between LCS and tobacco treatment discussions due to multiple barriers. On-site tobacco treatment programs and post-screening messaging tailored to the LCS results are needed to maximize the health outcomes of LCS, including smoking quit rates and longer-term smoking-related morbidity and mortality.

scholarly journals OA09.01 Opt-Out Smoking Cessation Program in Lung Cancer Screening Provides Excellent Quit Rates

2019 ◽  
Vol 14 (10) ◽  
pp. S228
Author(s):  
R. Myers ◽  
S. Atkar-Khattra ◽  
S. Pillainayagam ◽  
S. Ladhar ◽  
K. Cho ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Smoking Cessation Program ◽  
Opt Out

scholarly journals Lung Cancer Screening and Smoking Cessation: A Teachable Moment?

2014 ◽  
Vol 106 (6) ◽  
Author(s):  
Stephen A. Deppen ◽  
Eric L. Grogan ◽  
Melinda C. Aldrich ◽  
Pierre P. Massion
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Teachable Moment

Lung cancer screening as a teachable moment for smoking cessation

Lung Cancer ◽  
2007 ◽  
Vol 56 (1) ◽  
pp. 125-134 ◽  
Author(s):  
Kathryn L. Taylor ◽  
Lisa Sanderson Cox ◽  
Nicole Zincke ◽  
Larina Mehta ◽  
Colleen McGuire ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Teachable Moment

scholarly journals Cost-Effectiveness of Smoking Cessation Interventions in the Lung Cancer Screening Setting: A Simulation Study

2021 ◽  
Author(s):  
Christopher J Cadham ◽  
Pianpian Cao ◽  
Jinani Jayasekera ◽  
Kathryn L Taylor ◽  
David T Levy ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Task Force ◽  
Lung Cancer Screening ◽  
Cancer Registries ◽  
Web Based ◽  
Screening Programs ◽  
Life Years

Abstract Background Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches. Methods We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios. Results Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence. Conclusion All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability.

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