Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
J Thorac Oncol. 2019 Sep;14(9):1528-1537. doi: 10.1016/j.jtho.2019.04.024. Epub 2019 May 8.
Smoking cessation activities incorporated into lung cancer screening programs have been broadly recommended, but studies to date have not shown increased quit rates associated with cessation programs in this setting. We aimed to determine the effectiveness of smoking cessation counseling in smokers presenting for lung cancer screening.
This study is a randomized control trial of an intensive telephone-based smoking cessation counseling intervention incorporating lung cancer screening results versus usual care (information pamphlet). All active smokers enrolled in the Alberta Lung Cancer Screening Study cohort were randomized on a 1:1 ratio with a primary endpoint of self-reported 30-day abstinence at 12 months.
A total of 345 active smokers participating in the screening study were randomized to active smoking cessation counseling (n = 171) or control arm (n = 174). Thirty-day smoking abstinence at 12 months post-randomization was noted in 22 of 174 (12.6%) and 24 of 171 (14.0%) of participants in the control and intervention arms, respectively, a 1.4% difference (95% confidence interval: -5.9 to 8.7, p = 0.7). No statistically significant differences in 7-day or point abstinence were noted, nor were differences at 6 months or 24 months.
A telephone-based smoking cessation counseling intervention incorporating lung cancer screening results did not result in increased 12-month cessation rates versus written information alone in unselected smokers undergoing lung cancer screening. Routine referral of all current smokers to counseling-based cessation programs may not improve long-term cessation in this patient cohort. Future studies should specifically focus on this subgroup of older long-term smokers to determine the optimal method of integrating smoking cessation with lung cancer screening (clinicaltrials.govNCT02431962).
已广泛推荐将戒烟活动纳入肺癌筛查计划，但迄今为止的研究并未显示在此环境下与戒烟计划相关的戒烟率增加。我们旨在确定在进行肺癌筛查的吸烟者中，戒烟咨询的有效性。
这是一项针对强化电话戒烟咨询干预措施（纳入肺癌筛查结果）与常规护理（信息手册）的随机对照试验。所有参加艾伯塔省肺癌筛查研究队列的活跃吸烟者按 1:1 的比例随机分组，主要终点为 12 个月时自我报告的 30 天戒烟率。
共有 345 名活跃吸烟者参加了筛查研究，随机分为积极戒烟咨询组（n=171）或对照组（n=174）。随机分组后 12 个月时，对照组有 22 名（12.6%）和干预组有 24 名（14.0%）参与者实现了 30 天戒烟，差异为 1.4%（95%置信区间：-5.9 至 8.7，p=0.7）。在 7 天或点戒烟方面未观察到统计学上的显著差异，6 个月或 24 个月也未观察到差异。
与单独提供书面信息相比，将肺癌筛查结果纳入电话式戒烟咨询干预措施并未导致未选择的肺癌筛查吸烟者 12 个月的戒烟率增加。常规将所有当前吸烟者转介至基于咨询的戒烟计划可能不会改善该患者群体的长期戒烟率。未来的研究应特别关注这组年龄较大的长期吸烟者，以确定将戒烟与肺癌筛查相结合的最佳方法（clinicaltrials.govNCT02431962）。
