title: Preliminary evaluation of a telephone-based smoking cessation intervention in the lung cancer screening setting: A randomized clinical trial.
abstract: Incorporating effective smoking cessation interventions into lung cancer screening (LCS) programs will be essential to realizing the full benefit of screening. We conducted a pilot randomized trial to determine the feasibility and efficacy of a telephone-counseling (TC) smoking cessation intervention vs. usual care (UC) in the LCS setting. In collaboration with 3 geographically diverse LCS programs, we enrolled current smokers (61.5% participation rate) who were: registered to undergo LCS, 50-77 years old, and had a 20+ pack-year smoking history. Eligibility was not based on readiness to quit. Participants completed pre-LCS (T0) and post-LCS (T1) telephone assessments, were randomized to TC (N=46) vs. UC (N=46), and completed a final 3-month telephone assessment (T2). Both study arms received a list of evidence-based cessation resources. TC participants also received up to 6 brief counseling calls with a trained cessation counselor. Counseling calls incorporated motivational interviewing and utilized the screening result as a motivator for quitting. The outcome was biochemically verified 7-day point prevalence cessation at 3-months post-randomization. Participants (56.5% female) were 60.2 (SD=5.4) years old and reported 47.1 (SD=22.2) pack years; 30% were ready to stop smoking in the next 30 days. TC participants completed an average of 4.4 (SD=2.3) sessions. Using intent-to-treat analyses, biochemically verified quit rates were 17.4% (TC) vs. 4.3% (UC), p<.05. This study provides preliminary evidence that telephone-based cessation counseling is feasible and efficacious in the LCS setting. As millions of current smokers are now eligible for lung cancer screening, this setting represents an important opportunity to exert a large public health impact on cessation among smokers who are at very high risk for multiple tobacco-related diseases. If this evidence-based, brief, and scalable intervention is replicated, TC could help to improve the overall cost-effectiveness of LCS.
  
  
  
  NCT02267096, https://clinicaltrials.gov.
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States. Electronic address: TAYLORKL@georgetown.edu.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Taylor
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
authors.forename: Charlotte J
authors.initials: CJ
authors.lastname: Hagerman
authors.affiliation: Department of Biostatistics, Bioinformatics, and Biomathematics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
authors.forename: George
authors.initials: G
authors.lastname: Luta
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
authors.forename: Paula G
authors.initials: PG
authors.lastname: Bellini
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States; Behavioral Health Group, Westat, Inc., Rockville, MD, United States.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Stanton
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States; The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC, United States.
authors.forename: David B
authors.initials: DB
authors.lastname: Abrams
authors.affiliation: Medstar Georgetown University Hospital, Washington, DC, United States.
authors.forename: Jenna A
authors.initials: JA
authors.lastname: Kramer
authors.affiliation: Medstar Georgetown University Hospital, Washington, DC, United States.
authors.forename: Eric
authors.initials: E
authors.lastname: Anderson
authors.affiliation: Sophia Gordon Cancer Center, Lahey Hospital and Medical Center, Burlington, MA, United States.
authors.forename: Shawn
authors.initials: S
authors.lastname: Regis
authors.affiliation: Sophia Gordon Cancer Center, Lahey Hospital and Medical Center, Burlington, MA, United States.
authors.forename: Andrea
authors.initials: A
authors.lastname: McKee
authors.affiliation: Sophia Gordon Cancer Center, Lahey Hospital and Medical Center, Burlington, MA, United States.
authors.forename: Brady
authors.initials: B
authors.lastname: McKee
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States; The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC, United States.
authors.forename: Ray
authors.initials: R
authors.lastname: Niaura
authors.affiliation: John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, United States.
authors.forename: Harry
authors.initials: H
authors.lastname: Harper
authors.affiliation: John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Ramsaier
mesh_terms: D000368:Aged; D003376:Counseling; D055088:Early Detection of Cancer; D018479:Early Intervention, Educational; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016540:Smoking Cessation; D013689:Telephone; D013997:Time Factors
keywords: Lung cancer screening; Randomized trial; Smoking cessation; Telephone counseling