National Heart and Lung Institute, Imperial College London; NIHR Imperial Biomedical Research Centre, Imperial College London; Royal Brompton and Harefield Hospitals.
National Heart and Lung Institute, Imperial College London; NIHR Imperial Biomedical Research Centre, Imperial College London.
Chest. 2023 Feb;163(2):455-463. doi: 10.1016/j.chest.2022.06.048. Epub 2022 Aug 4.
Lung cancer screening programs provide an opportunity to support people who smoke to quit, but the most appropriate model for delivery remains to be determined. Immediate face-to-face smoking cessation support for people undergoing screening can increase quit rates, but it is not known whether remote delivery of immediate smoking cessation counselling and pharmacotherapy in this context also is effective.
Does an immediate telephone smoking cessation intervention increase quit rates compared with usual care among a population enrolled in a targeted lung health check (TLHC)?
In a single-masked randomized controlled trial, people 55 to 75 years of age who smoke and attended a TLHC were allocated by day of attendance to receive either immediate telephone smoking cessation intervention (TSI) support (starting immediately and lasting for 6 weeks) with appropriate pharmacotherapy or usual care (UC; very brief advice to quit and signposting to smoking cessation services). The primary outcome was self-reported 7-day point prevalence smoking abstinence at 3 months. Differences between groups were assessed using logistic regression.
Three hundred fifteen people taking part in the screening program who reported current smoking with a mean ± SD age of 63 ± 5.4 years, 48% of whom were women, were randomized to TSI (n = 152) or UC (n = 163). The two groups were well matched at baseline. Self-reported quit rates were higher in the intervention arm, 21.1% vs 8.9% (OR, 2.83; 95% CI, 1.44-5.61; P = .002). Controlling for participant demographics, neither baseline smoking characteristics nor the discovery of abnormalities on low-dose CT imaging modified the effect of the intervention.
Immediate provision of an intensive telephone-based smoking cessation intervention including pharmacotherapy, delivered within a targeted lung screening context, is associated with increased smoking abstinence at 3 months.
ISRCTN registry; No.: ISRCTN12455871; URL: www.IRSCN.com.
肺癌筛查项目为支持吸烟者戒烟提供了机会，但最合适的实施模式仍有待确定。对接受筛查的人群立即进行面对面的戒烟支持，可以提高戒烟率，但目前尚不清楚在这种情况下，远程提供即时戒烟咨询和药物治疗是否也有效。
与常规护理相比，在参加目标性肺健康检查（TLHC）的人群中，立即进行电话戒烟干预是否会增加戒烟率？
在一项单盲随机对照试验中，年龄在 55 岁至 75 岁之间、吸烟且参加 TLHC 的人群，根据就诊日期，被分配接受立即进行的电话戒烟干预（TSI）支持（立即开始并持续 6 周），同时提供适当的药物治疗，或接受常规护理（UC；简短的戒烟建议和指向戒烟服务的路标）。主要结局是在 3 个月时通过自我报告的 7 天点流行率吸烟 abstinence 来评估。使用逻辑回归评估组间差异。
共有 315 名参加筛查计划的报告当前吸烟的人参与了研究，他们的平均年龄为 63 ± 5.4 岁，其中 48%为女性，被随机分配到 TSI（n=152）或 UC（n=163）组。两组在基线时匹配良好。干预组的自我报告戒烟率更高，为 21.1%与 8.9%（OR，2.83；95%CI，1.44-5.61；P=0.002）。控制参与者的人口统计学特征后，基线吸烟特征或低剂量 CT 成像发现异常均不能改变干预的效果。
在目标性肺癌筛查背景下，立即提供包括药物治疗在内的强化电话戒烟干预措施，与 3 个月时的吸烟 abstinence 增加有关。
ISRCTN 注册；编号：ISRCTN85311036；网址：www.IRSCN.com。
