Taylor Kathryn L, Hagerman Charlotte J, Luta George, Bellini Paula G, Stanton Cassandra, Abrams David B, Kramer Jenna A, Anderson Eric, Regis Shawn, McKee Andrea, McKee Brady, Niaura Ray, Harper Harry, Ramsaier Michael
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
Lung Cancer. 2017 Jun;108:242-246. doi: 10.1016/j.lungcan.2017.01.020. Epub 2017 Feb 15.
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.
将有效的戒烟干预措施纳入肺癌筛查（LCS）项目对于充分实现筛查的益处至关重要。我们进行了一项试点随机试验，以确定在LCS环境中电话咨询（TC）戒烟干预与常规护理（UC）相比的可行性和有效性。我们与3个地理位置不同的LCS项目合作，招募了当前吸烟者（参与率为61.5%），这些吸烟者：已注册接受LCS，年龄在50 - 77岁之间，有20包年及以上的吸烟史。入选标准不基于戒烟意愿。参与者完成了LCS前（T0）和LCS后（T1）的电话评估，被随机分为TC组（N = 46）和UC组（N = 46），并完成了最后的3个月电话评估（T2）。两个研究组都收到了一份基于证据的戒烟资源清单。TC组参与者还接受了由训练有素的戒烟顾问提供的最多6次简短咨询电话。咨询电话采用动机访谈，并将筛查结果作为戒烟的动力。结局指标是随机分组后3个月时经生化验证的7天点患病率戒烟情况。参与者（56.5%为女性）年龄为60.2（标准差 = 5.4）岁，报告的吸烟量为47.1（标准差 = 22.2）包年；30%的人准备在接下来的30天内戒烟。TC组参与者平均完成了4.4（标准差 = 2.3）次咨询。采用意向性分析，经生化验证的戒烟率在TC组为17.4%，在UC组为4.3%，p < 0.05。本研究提供了初步证据，表明在LCS环境中基于电话的戒烟咨询是可行且有效的。由于数以百万计的当前吸烟者现在有资格接受肺癌筛查，这种环境为对患多种烟草相关疾病风险极高的吸烟者的戒烟产生重大公共卫生影响提供了一个重要机会。如果这种基于证据、简短且可扩展的干预措施能够得到推广，TC可能有助于提高LCS的总体成本效益。
NCT02267096，https://clinicaltrials.gov 。
