Low-dose CT screening program may influence smoking behavior
Patients who participated in lung cancer screening with low-dose CT achieved a greater smoking cessation rate after a year than those who did not participate in the program, according to study findings presented at the American Thoracic Society Annual Meeting. Shared decision-making visits did not significantly impact smoking behavior.
“We enroll patients in lung cancer screening based on their age and smoking history which means that many patients coming are active smokers,” Humberto Choi, MD, pulmonologist and lung cancer specialist at Cleveland Center, told Healio Family Medicine. “Lung cancer screening is ... an opportunity to discuss smoking cessation especially because we know that the benefits are greatest among patients who quit smoking.”
Researchers conducted a retrospective observational study of active smokers at the time of their baseline low-dose CT appointment between June 2012 and August 2016 (n = 128; 54% male; 85% white; mean age, 65 years). Researchers conducted telephone interviews to obtain the smoking history of each participant. Researchers then divided participants into three groups. Group one (n = 38) consisted of patients that had their baseline low-dose CT before the shared decision-making program was utilized at the institution. Some members of group one were also given smoking cessation guidance from the ordering provider. Group two (n = 38) had a shared decision-making visit with a subsequent low-dose CT. Members of group two were exposed to a discussion about the benefits of stopping smoking and were also given an information packet. Those in group three (n = 54) did not attend their appointment or complete the low-dose CT screening. Study participants self-reported whether they had abstained from smoking 1 year after the baseline low-dose CT was completed.
Researchers found that the overall rate of smoking abstinence 1 year after the lung cancer screening was 17%. Patients in groups one and two — those who had completed low-dose CT — had a higher abstinence rate than patients in group three (24% vs. 7%; P = .01). Patients in groups one and two (n = 56), who still smoked sometimes, decreased the number of cigarettes they smoked on a daily basis more frequently than those in group three (55% vs. 16%; P < .05). However, there was no significant difference between the abstinence rate in groups one and two, according to the researchers.
More research needs to be done to better understand these results, according to Choi. For instance, it is not clear why patients who received more intense counseling in the shared decision-making visits did not have higher smoking cessation rates.
“This suggests that we need to re-evaluate our interventions to make sure that they are appropriate and effective to this group of patients who participate in lung cancer screening,” Choi said. “One of the things that we are working on at the Cleveland Clinic is a new comprehensive Smoking Cessation program so we can offer easier access to evidence-based treatment and also to facilitate the short- and long-term follow up of these patients.” – by Melissa J. Webb
Rodrigues B, et al. Smoking cessation rates amongst participants and non-participants in a low-dose CT screening program. Presented at: American Thoracic Society Annual Conference; May 18-23; San Diego.
Disclosures: Healio Family Medicine was unable to confirm relevant financial disclosures prior to publication.