Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada.
Department of Medicine, Division of Respiratory Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
Can Respir J. 2022 Apr 21;2022:5446751. doi: 10.1155/2022/5446751. eCollection 2022.
Smoking cessation integration within lung cancer screening programs is challenging. Currently, phone counselling is available across Canada for individuals referred by healthcare workers and by self-referral. We compared quit rates after phone counselling interventions between participants who self-refer, those referred by healthcare workers, and those referred by a lung cancer screening program.
This is a retrospective cohort study of participants referred to provincial smoking cessation quit line in contemporaneous cohorts: self-referred participants, healthcare worker referred, and those referred by a lung cancer screening program if they were still actively smoking at the time of first contact. Baseline, covariates (sociodemographic information, smoking history, and history of mental health disorder) and quit intentions (stage of change, readiness for change, previous use of quit programs, and previous quit attempts) were compared among the three cohorts. Our primary outcome was defined as self-reported 30-day abstinence rates at 6 months. Multivariable logistic regression was used to identify whether group assignment was associated with higher quit rates.
Participants referred by a lung cancer screening program had low quit rates (12%, 95% CI: 5-19) at six months despite the use of phone counselling. Compared to patients who were self-referred to the smoking cessation phone helpline, individuals referred by a lung cancer screening program were much less likely to quit (adjusted OR 0.37; 95% CI: 0.17-0.8), whereas those referred by healthcare workers were twice as likely to quit (adjusted OR 2.16 (1.3-3.58)) even after adjustment for differences in smoking intensity and quit intentions.
Phone counselling alone has very limited benefit in a lung cancer screening program. Participants differ significantly from those who are otherwise referred by healthcare workers. This study underlines the importance of a dedicated and personalized tobacco treatment program within every lung cancer screening program. The program should incorporate best practices and encourage treatment regardless of readiness to quit.
在肺癌筛查计划中整合戒烟服务具有挑战性。目前，加拿大各地为卫生保健工作者转介和自我转介的个人提供电话咨询服务。我们比较了通过电话咨询干预后，自我转介、卫生保健工作者转介和肺癌筛查计划转介的参与者的戒烟率。
这是一项回顾性队列研究，研究对象为同时期被省级戒烟热线转介的参与者：自我转介的参与者、卫生保健工作者转介的参与者以及首次联系时仍在吸烟的肺癌筛查计划转介的参与者。在三个队列中比较了基线、协变量（社会人口统计学信息、吸烟史和精神健康障碍史）和戒烟意愿（改变阶段、改变准备度、以前使用戒烟计划和以前的戒烟尝试）。我们的主要结局是定义为 6 个月时自我报告的 30 天 abstinence 率。使用多变量逻辑回归来确定分组是否与更高的戒烟率相关。
尽管使用了电话咨询，肺癌筛查计划转介的参与者在 6 个月时的戒烟率仍然很低（12%，95%CI：5-19）。与自我转介到戒烟热线的患者相比，肺癌筛查计划转介的患者戒烟的可能性要小得多（调整后的 OR 0.37；95%CI：0.17-0.8），而卫生保健工作者转介的患者戒烟的可能性要高出两倍（调整后的 OR 2.16（1.3-3.58）），即使在调整吸烟强度和戒烟意愿的差异后也是如此。
单独的电话咨询在肺癌筛查计划中效果非常有限。参与者与其他卫生保健工作者转介的参与者有很大的不同。这项研究强调了在每个肺癌筛查计划中都需要一个专门和个性化的烟草治疗计划的重要性。该计划应纳入最佳实践，并鼓励治疗，无论是否准备戒烟。
