Predictors of attrition in a smoking cessation trial conducted in the lung cancer screening setting

Kim, Emily; Williams, Randi M.; Eyestone, Ellie; Cordon, Marisa; Smith, Laney; Davis, Kimberly M.; Luta, George; Anderson, Eric; McKee, Brady; Batlle, Juan C.; Ramsaier, Michael; Howell, Judith; Parikh, Vicky; Geronimo, Maria; Stanton, Cassandra A.; Niaura, Raymond; Abrams, David B.; Taylor, Kathryn L.; Screening, Tobacco Lung

doi:10.1016/j.cct.2021.106429

Cited by 6 publications

(9 citation statements)

References 31 publications

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“…In a separate article, we examined characteristics of those individuals who were retained versus those who dropped out between the 2 assessments. 39 In brief, retention was higher among those who smoked <20 CPD, were more highly educated (more than a high school diploma/General Education Development degree), somewhat worried about lung cancer (vs not at all worried), undergoing their annual lung cancer screening examination (vs a baseline scan), and had Lung-RADS 2 and 3 examination results compared with a Lung-RADS 1 result. Regarding how this sample may compare with a larger population, there has been limited research on smoking attitudes among the population of individuals undergoing lung screening, but some studies have reported higher quit rates among participants in lung screening programs compared with the general population of individuals who smoke, which may be explained by differences in background demographics and levels of motivation.…”

Section: Discussionmentioning

confidence: 99%

“…The current sample may be a more motivated group relative to those who did not remain in the trial because they were retained at the T1 (after lung screening) interview. In a separate article, we examined characteristics of those individuals who were retained versus those who dropped out between the 2 assessments 39 . In brief, retention was higher among those who smoked <20 CPD, were more highly educated (more than a high school diploma/General Education Development degree), somewhat worried about lung cancer (vs not at all worried), undergoing their annual lung cancer screening examination (vs a baseline scan), and had Lung‐RADS 2 and 3 examination results compared with a Lung‐RADS 1 result.…”

Section: Discussionmentioning

confidence: 99%

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Improved motivation and readiness to quit shortly after lung cancer screening: Evidence for a teachable moment

Williams

Cordon

Eyestone

et al. 2022

Cancer

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BACKGROUND: For patients at high risk for lung cancer, screening using low-dose computed tomography (lung cancer screening [LCS]) is recommended. The purpose of this study was to examine whether screening may serve as a teachable moment for smokingrelated outcomes. METHODS: In a smoking-cessation trial, participants (N = 843) completed 2 phone interviews before randomization: before LCS (T0) and after LCS (T1). By using logistic and linear regression, the authors examined teachable moment variables (perceived risk, lung cancer worry) and outcomes (readiness, motivation, and cigarettes per day [CPD]). RESULTS: Participants were a mean ± SD age of 63.7 ± 5.9 years, had 47.8 ± 7.1 pack-years of smoking, 35.2% had a high school diploma or General Educational Development (high school equivalency) degree or less, and 42.3% were undergoing their first scan. Between T0 and T1, 25.7% of participants increased readiness to quit, 9.6% decreased readiness, and 64.7% reported no change (P < .001). Motivation to quit increased (P < .05) and CPD decreased between assessments (P < .001), but only 1.3% self-reported quitting. Compared with individuals who reported no lung cancer worry/little worry, extreme worry was associated with readiness to quit in the next 30 days (odds ratio, 1.8; 95% CI, 1.1-3.0) and with higher motivation (b = 0.83; P < .001) at T1. Individuals undergoing a baseline (vs annual) scan were more ready to quit in the next 30 days (odds ratio, 1.8; 95% CI, 1.3-2.5). CONCLUSIONS: During the brief window between registering for LCS and receiving the results, the authors observed that very few participants quit smoking, but a significant proportion improved on readiness and motivation to quit, particularly among individuals who were undergoing their first scan and those who were extremely worried about lung cancer. These results indicate that providing evidence-based tobacco treatment can build upon this teachable moment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improved motivation and readiness to quit shortly after lung cancer screening: Evidence for a teachable moment

Williams

Cordon

Eyestone

et al. 2022

Cancer

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“…The caveat of potential decreased motivation resulting from receiving an ‘all clear’ has also been identified as a concern among screening staff 45 and the current study participants. There is currently no evidence to support that a ‘licence to smoke’ occurs in practice 46 although a US‐based smoking cessation trial found that attrition was higher for participants who had negative LDCT scan results 47 . Ongoing research will help to clarify the impact of the receipt of a personalized cessation discussion incorporating scan results alongside communication to support self‐efficacy and improved health consequences from cessation regardless of the type of result 48 .…”

Section: Discussionmentioning

confidence: 99%

“…There is currently no evidence to support that a ‘licence to smoke’ occurs in practice 46 although a US‐based smoking cessation trial found that attrition was higher for participants who had negative LDCT scan results. 47 Ongoing research will help to clarify the impact of the receipt of a personalized cessation discussion incorporating scan results alongside communication to support self‐efficacy and improved health consequences from cessation regardless of the type of result. 48 A self‐help booklet intervention development project has also targeted negative results, with screening eligible individuals shaping a booklet section regarding ‘dodging the bullet’, discussing the dilemma faced by individuals with a negative screening result regarding smoking cessation.…”

Section: Discussionmentioning

confidence: 99%

Attitudes towards the integration of smoking cessation into lung cancer screening in the United Kingdom: A qualitative study of individuals eligible to attend

Groves

McCutchan

Quaife

et al. 2022

Health Expectations

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Introduction: There is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible.Methods: Thirty-one lung cancer screening eligible individuals aged 55-80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual

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“…Offering multiple accrual methods and at multiple points over the screening may help to engage the smokers, and providing pharmacotherapy options promotes enrolment [118]. Retention and treatment engagement differ on demographic, clinical, and psychological characteristics (e.g., number of cigarettes smoked per day, education, worry about lung cancer, screening results) [119].…”

Section: Smoking Cessationmentioning

confidence: 99%

Two decades of ITALUNG. What we have learned and what is yet to be addressed in lung cancer screening with low dose CT.

Mascalchi¹,

Picozzi²,

Puliti³

et al. 2023

Preprint

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The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55-69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as Lung Cancer associated with Cystic Airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs biennial pace of LDCT, choice between opportunistic or population-based recruitment and between uni or multi-center screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention and prospective validation of the biomarkers.

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Predictors of attrition in a smoking cessation trial conducted in the lung cancer screening setting

Cited by 6 publications

References 31 publications

Improved motivation and readiness to quit shortly after lung cancer screening: Evidence for a teachable moment

Improved motivation and readiness to quit shortly after lung cancer screening: Evidence for a teachable moment

Attitudes towards the integration of smoking cessation into lung cancer screening in the United Kingdom: A qualitative study of individuals eligible to attend

Two decades of ITALUNG. What we have learned and what is yet to be addressed in lung cancer screening with low dose CT.

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