Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
2nd Radiodiagnostic Unit, Department of Diagnostic Imaging, University Hospital of Pisa, Pisa, Italy.
Nicotine Tob Res. 2020 Aug 24;22(9):1484-1491. doi: 10.1093/ntr/ntz148.
BACKGROUND: Changes in smoking habits and predictors of smoking cessation were examined in the randomized ITALUNG lung cancer screening trial. METHODS: In three centers, eligible smokers or ex-smokers (55-69 years, ≥20 pack-years in the last 10 years) were randomized to receive annual invitation for low-dose computed tomography for 4 years or usual care. At invitation, subjects received written information for a free smoking cessation program. Quitting outcome was assessed at year 4. RESULTS: Among participants who completed baseline assessments and year 4 screening, higher quitting (20.8% vs. 16.7%, p = .029) and lower relapse (6.41% vs. 7.56%, p = .50) rates were observed in the active screening group as compared to the usual-care control group. Corresponding figures in the intention-to-treat analysis were as follows: 16.04% versus 14.64% (p = .059) and 4.88% versus 6.43% (p = .26). Quitting smoking was significantly associated to male gender, lower pack-years, and having pulmonary nodules at baseline. Center-specific analyses showed a threefold statistically significant higher probability to quit associated with participating in the smoking cessation program. A subsample of smokers of the scan group from one center showed higher quitting rates over 12-month follow-up as compared to matched controls from the general population who underwent the same smoking cessation program. CONCLUSIONS: Consistently with previous reports, in the ITALUNG trial, screened subjects showed significantly higher quit rates than controls, and higher quit rates were associated with both the presence of pulmonary nodules and participating in a smoking cessation program. Maximal effect on quitting outcome was observed with the participation in the smoking cessation program. IMPLICATIONS: Participating in lung cancer screening promotes smoking cessation. An effective "teachable moment" may be achieved when the smoking cessation intervention is structured as integral part of the screening clinical visits and conducted by a dedicated team of health care professionals. Standardized guidelines for smoking cessation interventions in lung cancer screening are needed.
背景：在随机的 ITALUNG 肺癌筛查试验中，研究了吸烟习惯的变化和戒烟的预测因素。
方法：在三个中心，符合条件的吸烟者或戒烟者（55-69 岁，过去 10 年中≥20 包年）被随机分配接受为期 4 年的低剂量计算机断层扫描年度邀请或常规护理。在邀请时，受试者收到了免费戒烟计划的书面信息。在第 4 年评估戒烟结果。
结果：在完成基线评估和第 4 年筛查的参与者中，与常规护理对照组相比，主动筛查组的戒烟率（20.8%比 16.7%，p=0.029）和复发率（6.41%比 7.56%，p=0.50）均较高。意向治疗分析的相应数据如下：16.04%比 14.64%（p=0.059）和 4.88%比 6.43%（p=0.26）。戒烟与男性性别、较低的吸烟包年数和基线时存在肺结节显著相关。中心特异性分析显示，参加戒烟计划与戒烟的可能性增加三倍有统计学意义。来自一个中心的扫描组的吸烟者亚样本在 12 个月的随访中显示出比接受相同戒烟计划的一般人群中的匹配对照更高的戒烟率。
结论：与之前的报告一致，在 ITALUNG 试验中，筛查组的受试者戒烟率明显高于对照组，且戒烟率与肺结节的存在和参加戒烟计划均相关。参加戒烟计划对戒烟结果的影响最大。
意义：参加肺癌筛查可促进戒烟。当戒烟干预作为筛查临床访问的组成部分并由专门的医疗保健专业人员团队进行时，可能会出现有效的“可教时刻”。需要制定肺癌筛查中戒烟干预的标准化指南。
Nicotine Tob Res. 2020-8-24
Lung Cancer. 2007-4
Breathe (Sheff). 2024-8-27
Lancet Reg Health Eur. 2024-6-24
Eur Radiol. 2025-1
Diagnostics (Basel). 2023-6-28
Zotero 插件