title: A combined smoking cessation intervention within a lung cancer screening trial: a pilot observational study.
abstract: OBJECTIVE
  The time of lung cancer screening may provide the ideal setting to discuss and initiate a smoking cessation plan that includes pharmacologic aids. No studies to date have fully investigated the potential effectiveness of such combined approach.
  
  
  METHODS
  We prospectively evaluated the biochemically verified 1-year continuous abstinence rate from smoking of 187 persistent smokers enrolled within the Multicentric Italian Lung Detection Trial (MILD), who received a pharmacologic aid to quit smoking with varenicline along with behavioral counseling. The propensity of study subjects to succeed in smoking cessation was also monitored.
  
  
  RESULTS
  At 12 months, the continuous abstinence rate from smoking was achieved in 37 out of 187 patients (19.8%), with a propensity to succeed in smoking cessation for the assisted attempt equal to 1.43, as compared to an unassisted MILD patient. At the end of the third month of therapy, 48.7% of subjects showed a continuous abstinence rate, while only 33.7% of patients were abstinent from smoking at 6 months. At baseline, the subgroup of MILD participants who were originally allocated to lung tomography showed higher smoking intensity than those allocated to no screening.
  
  
  CONCLUSIONS
  A combined smoking cessation intervention can be implemented with satisfactory results within a lung cancer screening program; this preliminary observation needs to be replicated in a prospective investigation. Clinicians should consider that lung cancer screening may be falsely reassuring for persistent smokers; therefore it should always be coupled with a smoking cessation program.
authors.affiliation: 1 Tobacco Control Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pozzi
authors.forename: Elena
authors.initials: E
authors.lastname: Munarini
authors.forename: Francesca
authors.initials: F
authors.lastname: Bravi
authors.forename: Marta
authors.initials: M
authors.lastname: Rossi
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.forename: Roberto
authors.initials: R
authors.lastname: Boffi
authors.forename: Ugo
authors.initials: U
authors.lastname: Pastorino
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000008:administration & dosage; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage; D055088:Early Detection of Cancer / Q000379:methods; D005500:Follow-Up Studies; D007558:Italy / Q000453:epidemiology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D008403:Mass Screening / Q000379:methods; D018722:Nicotinic Agonists / Q000627:therapeutic use; D010865:Pilot Projects; D057216:Propensity Score; D011446:Prospective Studies; D011810:Quinoxalines / Q000627:therapeutic use; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods; D061485:Tobacco Use Cessation Devices / Q000009:adverse effects; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D016642:Bupropion; D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline