scholarly journals Yorkshire Enhanced Stop Smoking (YESS) study: a protocol for a randomised controlled trial to evaluate the effect of adding a personalised smoking cessation intervention to a lung cancer screening programme

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037086
Author(s):  
Rachael L Murray ◽  
Kate Brain ◽  
John Britton ◽  
Harriet D Quinn-Scoggins ◽  
Sarah Lewis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Ct Scan ◽  
Perceived Risk ◽  
Controlled Trial ◽  
Lung Cancer Screening ◽  
Link Type ◽  
Quit Smoking ◽  
Stop Smoking

IntroductionIntegration of smoking cessation (SC) into lung cancer screening is essential to optimise clinical and cost effectiveness. The most effective way to use this ‘teachable moment’ is unclear. The Yorkshire Enhanced Stop Smoking study will measure the effectiveness of an SC service integrated within the Yorkshire Lung Screening Trial (YLST) and will test the efficacy of a personalised SC intervention, incorporating incidental findings detected on the low-dose CT scan performed as part of YLST.Methods and analysisUnless explicitly declined, all smokers enrolled in YLST will see an SC practitioner at baseline and receive SC support over 4 weeks comprising behavioural support, pharmacotherapy and/or a commercially available e-cigarette. Eligible smokers will be randomised (1:1 in permuted blocks of random size up to size 6) to receive either an enhanced, personalised SC support package, including CT scan images, or continued standard best practice. Anticipated recruitment is 1040 smokers (January 2019–December 2020). The primary objective is to measure 7-day point prevalent carbon monoxide (CO) validated SC after 3 months. Secondary outcomes include CO validated cessation at 4 weeks and 12 months, self-reported continuous cessation at 4 weeks, 3 months and 12 months, attempts to quit smoking and changes in psychological variables, including perceived risk of lung cancer, motivation to quit smoking tobacco, confidence and efficacy beliefs (self and response) at all follow-up points. A process evaluation will explore under which circumstances and on which groups the intervention works best, test intervention fidelity and theory test the mechanisms of intervention impact.Ethics and disseminationThis study has been approved by the East Midlands-Derby Research Ethics Committee (18/EM/0199) and the Health Research Authority/Health and Care Research Wales. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via the YLST website.Trial registration numbersISRCTN63825779, NCT03750110.

scholarly journals AB0253 A REVIEW OF SMOKING CESSATION STRATEGIES AND LUNG CANCER SCREENING PRACTICES IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1426.2-1426
Author(s):  
M. A. Lopez-Olivo ◽  
R. Volk ◽  
K. J. Krause ◽  
M. Suarez-Almazor
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Lung Cancer Screening ◽  
Nicotine Replacement ◽  
Screening Practices ◽  
Quit Smoking

Background:Smoking rates among patients with rheumatoid arthritis (RA) exceed those reported in the general population. In addition, people with RA who smoke are more likely to develop lung cancer than smokers who do not have RA.Objectives:To identify smoking cessation strategies and lung cancer screening practices in patients with RA.Methods:We conducted a review of the literature in electronic databases (i.e., PubMed, EMBASE, Cochrane, Scopus, and Web of Science) from inception until June 2019. We included studies that reported on the results of interventions for smoking cessation or lung cancer screening in patients with RA. We excluded case reports, reviews, guidelines, protocols, or studies on tobacco use not reporting interventions. We included studies published in abstract or full-text format. We extracted study and intervention characteristics including delivery format, timing and results.Results:We retrieved 394 relevant citations and ultimately included 9 studies evaluating smoking cessation strategies, and one regarding lung cancer screening practices. Five studies were reported in abstract format. There were 3 studies conducted in the United Kingdom, and one each in Croatia, France, Ireland, New Zealand, Sweden, Spain and United States. Two studies were randomized control trials and the remaining were uncontrolled. Follow-up ranged between 1 month and 24 months, however, one study only reported data on the assessment immediately after the intervention. Sample sizes ranged between 20 and 185 current smokers. Smoking cessation strategies included: 1) brief advice and nicotine replacement therapy + smoking cessation counseling for 3 months; 2) information booklet on harms of smoking (i.e., impact on disease and treatment); 3) spoken information on harms of smoking (i.e., impact on disease and treatment) plus advice to quit smoking; 4) advice to quit smoking plus nicotine replacement; 5) smoking cessation support with contact every 4 weeks; 6) spoken information on harms of smoking (i.e., impact on disease and treatment) plus advice to quit smoking plus nurse telephone visit at 3rdmonth; 6) staff driven tobacco QUIT line referral process; 7) multi-modality intervention with advise to quit smoking plus guidance on safe alcohol use plus dietary advise with booklet and swimming group. The lung cancer screening study reported on a program with nurse evaluation of comorbidities and risk factors, and recommendations for lung cancer screening with a chest X-ray and smoking cessation. Most studies reported benefits when implementing a structured plan to educate, counsel, and offer pharmacological treatment to patients with RA.Conclusion:There was large heterogeneity among studies in patient characteristics and interventions proposed, and outcomes. Only 2 studies were randomized clinical trials. Additional controlled studies are needed to determine best practices for smoking cessation and lung cancer screening in patients with RA.Disclosure of Interests:None declared

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.

Overwhelming Support Among Urban Irish COPD Patients for Lung Cancer Screening by Low-Dose CT Scan

Lung ◽  
2012 ◽  
Vol 190 (6) ◽  
pp. 621-628 ◽  
Author(s):  
M. Pallin ◽  
S. Walsh ◽  
M. F. O’Driscoll ◽  
C. Murray ◽  
A. Cahalane ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Ct Scan ◽  
Low Dose ◽  
Lung Cancer Screening ◽  
Low Dose Ct ◽  
Copd Patients
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