Immediate, Remote Smoking Cessation Intervention in Participants Undergoing a Targeted Lung Health Check

Williams, P. K.; Philip, Keir EJ.; Gill, Navjot Kaur; Flannery, Deirdre; Buttery, Sara; Bartlett, Emily; Devaraj, Anand; Kemp, Samuel V.; Addis, Jamie; Derbyshire, Jane; Chen, Michelle; Morris, Katie; Hopkinson, Nicholas S

doi:10.1016/j.chest.2022.06.048

Cited by 13 publications

(6 citation statements)

References 20 publications

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“…Comparison with other literature Direct comparison with other studies is limited by differences in participant populations, follow-up duration and definitions of quitting for calculating quit rates. Several studies report quit data at 12 weeks following the screening visit, so are not comparable to the data presented here collected only 4 weeks after screening [31][32][33][34]. The only study documenting quit rates at a similar time-point was an analysis of people undergoing LDCT screening in the UK Lung Screening Pilot.…”

Section: Discussionmentioning

confidence: 63%

Uptake and 4-week quit rates from an opt-out co-located smoking cessation service delivered alongside community-based low-dose computed tomography screening within the Yorkshire Lung Screening Trial

Murray,

Alexandris,

Baldwin

et al. 2024

Eur Respir J

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BackgroundUp to 50% of those attending for low-dose computed tomography screening for lung cancer continue to smoke and co-delivery of smoking cessation services alongside screening may maximise clinical benefit. Here we present data from an opt-out co-located smoking cessation service delivered alongside the Yorkshire Lung Screening Trial (YLST).MethodsEligible YLST participants were offered an immediate consultation with a smoking cessation practitioner (SCP) at their screening visit with ongoing smoking cessation support over subsequent weeks.ResultsOf 2150 eligible participants, 1905 (89%) accepted the offer of an SCP consultation during their initial visit, with 1609 (75%) receiving ongoing smoking cessation support over subsequent weeks. Uptake of ongoing support was not associated with age, ethnicity, deprivation or educational level in multivariable analyses, although men were less likely to engage (adjusted OR (ORadj) 0.71, 95% CI 0.56–0.89). Uptake was higher in those with higher nicotine dependency, motivation to stop smoking and self-efficacy for quitting. Overall, 323 participants self-reported quitting at 4 weeks (15.0% of the eligible population); 266 were validated by exhaled carbon monoxide (12.4%). Multivariable analyses of eligible smokers suggested 4-week quitting was more likely in men (ORadj1.43, 95% CI 1.11–1.84), those with higher motivation to quit and previous quit attempts, while those with a stronger smoking habit in terms of cigarettes per day were less likely to quit.ConclusionsThere was high uptake for co-located opt-out smoking cessation support across a wide range of participant demographics. Protected funding for integrated smoking cessation services should be considered to maximise programme equity and benefit.

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Section: Discussionmentioning

confidence: 63%

Uptake and 4-week quit rates from an opt-out co-located smoking cessation service delivered alongside community-based low-dose computed tomography screening within the Yorkshire Lung Screening Trial

Murray,

Alexandris,

Baldwin

et al. 2024

Eur Respir J

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“…At that moment, novel cessation approaches can be a solution for this vulnerable group: immediate cessation support, regardless of smoker patients’ preparedness 21 , 22 . Effective counselling, by following the cessation medication as well as following with or without remote follow-up, was shown to be more effective than the routine approach 23 . The purpose of ‘teachable moments’, such as the diagnosis of a tobacco-related illness, is to encourage smokers to stop; consequently, healthcare practitioners of patients with chronic respiratory disorders should use these opportunities effectively.…”

Section: Discussionmentioning

confidence: 99%

Neglecting the neglected: Tobacco cessation support is 'essential' for the management of asthma and COPD

Karadogan,

Kaya,

Yumrukuz Şenel

et al. 2024

Tob. Induc. Dis.

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INTRODUCTION Asthma and COPD management have a broad framework, and smoking cessation plays an essential role. We examine the management of asthma and COPD patients not only for inhaler treatment options but also for essential interventions, such as smoking cessation support. METHODS Data were collected cross-sectionally from pulmonology departments of three government hospitals in Türkiye between May and September 2022. Patients aged ≥18 years who had been diagnosed with asthma or COPD for at least a year, were included in the study. The demographic and clinical characteristics of the patients were investigated. Routine cessation interventions were implemented for current smokers, and they were followed via phone calls after one month regarding their quit status and access to cessation clinics. RESULTS Data from 145 patients with asthma and 148 patients with COPD were analyzed. The rate of current smoking among patients with asthma and COPD was 18.8% and 34.5%, respectively. Current smoking was negatively associated with age (<65 years) and disease duration (years) for both diseases (p<0.05). In addition, for asthmatics, presence of pulmonary disease in the family (OR:0.28, 95% CI: 0.10-0.79) and for COPD patients presence of hospitalization (OR: 0.26, 95% CI: 0.07-0.93) were negatively associated with current smoking. After one month, 85.1% of current asthmatic smokers had not tried to call a quitline, while 14.8% had tried to contact a quitline. Among current smoker COPD patients, only 1.9% had visited a smoking cessation clinic. CONCLUSIONS Tobacco cessation support seems to be neglected in asthma and COPD management. Instead, pulmonologists and patients focus on pharmaceutical treatments, which constitute the other component of care.

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“…In 2 other SCALE trials, Foley et al reported 7-day abstinence rates of 13% at 6 months, and Tremblay et al reported 30-day abstinence rates of 13% to 14%. Clinical observational studies have reported quit rates in the LCS setting of 9% to 14% . Modeling studies support that integrating tobacco treatment with LCS yields cost-benefits of similar magnitude of LCS itself; for example, adding a tobacco cessation intervention with an effectiveness of 15% results in equivalent life-years gained as increasing LCS uptake from 30% to 100% .…”

Section: Discussionmentioning

confidence: 99%

“…Clinical observational studies have reported quit rates in the LCS setting of 9% to 14%. 33 , 34 , 35 Modeling studies support that integrating tobacco treatment with LCS yields cost-benefits of similar magnitude of LCS itself; for example, adding a tobacco cessation intervention with an effectiveness of 15% results in equivalent life-years gained as increasing LCS uptake from 30% to 100%. 36 The quit rates observed in PLUTO suggest that the investment of resources to adopt a chronic care model in the LCS setting would be effective and cost-effective.…”

Section: Discussionmentioning

confidence: 99%

Optimizing Longitudinal Tobacco Cessation Treatment in Lung Cancer Screening

Fu,

Rothman,

Vock

et al. 2023

JAMA Netw Open

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ImportanceNearly half of the 14.8 million US adults eligible for lung cancer screening (LCS) smoke cigarettes. The optimal smoking cessation program components for the LCS setting are unclear.ObjectiveTo assess the effect of adding a referral to prescription medication therapy management (MTM) to the tobacco longitudinal care (TLC) program among patients eligible for LCS who smoke and do not respond to early tobacco treatment and to assess the effect of decreasing the intensity of TLC among participants who do respond to early treatment.Design, Setting, and ParticipantsThis randomized clinical trial included patients who currently smoked cigarettes daily and were eligible for LCS. Recruitment took place at primary care centers and LCS programs at 3 large health systems in the US and began in October 2016, and 18-month follow-up was completed April 2021.Interventions(1) TLC comprising intensive telephone coaching and combination nicotine replacement therapy for 1 year with at least monthly contact; (2) TLC with MTM, MTM offered pharmacist-referral for prescription medications; and (3) Quarterly TLC, intensity of TLC was decreased to quarterly contact. Intervention assignments were based on early response to tobacco treatment (abstinence) that was assessed either 4 weeks or 8 weeks after treatment initiation.Main outcomes and MeasuresSelf-reported, 6-month prolonged abstinence at 18-month.ResultsOf 636 participants, 228 (35.9%) were female, 564 (89.4%) were White individuals, and the median (IQR) age was 64.3 (59.6-68.8) years. Four weeks or 8 weeks after treatment initiation, 510 participants (80.2%) continued to smoke (ie, early treatment nonresponders) and 126 participants (19.8%) had quit (ie, early treatment responders). The 18 month follow-up survey response rate was 83.2% (529 of 636). Across TLC groups at 18 months follow-up, the overall 6-month prolonged abstinence rate was 24.4% (129 of 529). Among the 416 early treatment nonresponders, 6-month prolonged abstinence for TLC with MTM vs TLC was 17.8% vs 16.4% (adjusted odds ratio [aOR] 1.13; 95% CI, 0.67-1.89). In TLC with MTM, 98 of 254 participants (39%) completed at least 1 MTM visit. Among 113 early treatment responders, 6-month prolonged abstinence for Quarterly TLC vs TLC was 24 of 55 (43.6%) vs 34 of 58 (58.6%) (aOR, 0.54; 95% CI, 0.25-1.17).Conclusions and RelevanceIn this randomized clinical trial, adding referral to MTM with TLC for participants who did not respond to early treatment did not improve smoking abstinence. Stepping down to Quarterly TLC among early treatment responders is not recommended. Integrating longitudinal tobacco cessation care with LCS is feasible and associated with clinically meaningful quit rates.Trial RegistrationClinicalTrials.gov Identifier: NCT02597491

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Immediate, Remote Smoking Cessation Intervention in Participants Undergoing a Targeted Lung Health Check

Cited by 13 publications

References 20 publications

Uptake and 4-week quit rates from an opt-out co-located smoking cessation service delivered alongside community-based low-dose computed tomography screening within the Yorkshire Lung Screening Trial

Uptake and 4-week quit rates from an opt-out co-located smoking cessation service delivered alongside community-based low-dose computed tomography screening within the Yorkshire Lung Screening Trial

Neglecting the neglected: Tobacco cessation support is 'essential' for the management of asthma and COPD

Optimizing Longitudinal Tobacco Cessation Treatment in Lung Cancer Screening

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