The Ohio State University College of Public Health, Columbus, OH 43210, USA.
Lung Cancer. 2012 May;76(2):211-5. doi: 10.1016/j.lungcan.2011.10.011. Epub 2011 Nov 15.
Lung cancer screening with computed tomography has demonstrated a significant reduction in mortality. While these findings are important for the lung cancer research field, the most important risk factor for lung cancer, i.e. smoking, should not be ignored. We performed a pilot study to examine the feasibility of delivering a program that included both tobacco dependence treatment and lung cancer screening. The objectives of this study were to: (1) estimate the proportion of smokers who complied with a 12-week treatment protocol that included both tobacco dependence treatment and lung cancer screening, (2) obtain preliminary estimates of abstinence and quit attempts at 4 and 6 months, and (3) obtain preliminary estimates of the cognitive social health information processing (C-SHIP) constructs and how they change following the intervention. In this randomized pilot study, 18 volunteers completed a 12-week protocol: half received the tobacco dependence treatment program before a CT scan (BCT) and the other received the CT scan first, followed by the treatment program (ACT). The treatment protocol included both nurse-delivered telephone counseling and either nicotine replacement therapy or varenicline. Only one person did not complete all follow-up evaluations. At 4 months post enrollment, the carbon monoxide confirmed quit rates were 33.3% in the BCT arm and 22.2% in the ACT arm (27.8% overall), and all but one had made a 24-h attempt to quit. At 6 months the confirmed abstinence decreased to 22.1% in the BCT arm and 11.1% in the ACT arm (16.7% overall), and 72.2% of participants had made a 24-h quit attempt. These preliminary results suggest that it might be better to deliver treatment before the screening test. Future randomized trials with a larger sample size are needed to confirm these findings.
肺癌筛查的计算机断层扫描(CT)已证明能显著降低死亡率。虽然这些发现对肺癌研究领域很重要,但肺癌最重要的危险因素,即吸烟,不应被忽视。我们进行了一项试点研究,以检验包括烟草依赖治疗和肺癌筛查在内的方案的可行性。本研究的目的是:(1)估计遵守包括烟草依赖治疗和肺癌筛查的 12 周治疗方案的吸烟者比例;(2)在 4 个月和 6 个月时获得初步的戒烟和尝试戒烟率;(3)初步评估认知社会健康信息处理(C-SHIP)的结构及其在干预后的变化。在这项随机试点研究中,18 名志愿者完成了 12 周的方案:一半人在 CT 扫描前接受烟草依赖治疗方案(BCT),另一半人先接受 CT 扫描,然后再接受治疗方案(ACT)。治疗方案包括护士提供的电话咨询和尼古丁替代疗法或伐尼克兰。只有 1 人未完成所有随访评估。在入组后 4 个月,BCT 组的一氧化碳确认戒烟率为 33.3%,ACT 组为 22.2%(总体为 27.8%),且所有人都尝试了 24 小时戒烟。在 6 个月时,BCT 组的确认戒烟率降至 22.1%,ACT 组降至 11.1%(总体为 16.7%),72.2%的参与者进行了 24 小时的戒烟尝试。这些初步结果表明,在筛查前进行治疗可能会更好。需要更大样本量的未来随机试验来证实这些发现。