Research Department of Behavioural Science and Health, University College London, London, United Kingdom.
Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Addiction. 2023 Oct;118(10):2007-2013. doi: 10.1111/add.16269. Epub 2023 Jun 18.
Optimising smoking cessation (SC) referral strategies within lung cancer screening (LCS) could significantly reduce lung cancer mortality. This study aimed to measure acceptance of referral to SC support by either practitioner-referral or self-referral among participants attending a hospital-based lung health check appointment for LCS as part of the Lung Screen Uptake Trial.
Single-blinded two-arm randomised controlled trial.
England.
Six hundred forty-two individuals ages 60 to 75 years, who self-reported currently smoking or had a carbon monoxide reading over 10 ppm during the lung health check appointment.
Participants were randomised (1:1) to receive either a contact information card for self-referral to a local stop smoking service (SSS) (self-referral, n = 360) or a SSS referral made on their behalf by the nurse or trial practitioner (practitioner-referral, n = 329).
The primary outcome was acceptance of the practitioner-referral (defined as participants giving permission for their details to be shared with the local SSS) compared with acceptance of the self-referral (defined as participants taking the physical SSS contact information card to refer themselves to the local SSS).
Half (49.8%) accepted the practitioner-made referral to a local SSS, whereas most (88.5%) accepted the self-referral. The odds of accepting the practitioner-referral were statistically significantly lower (adjusted odds ratio = 0.10; 95% confidence interval = 0.06-0.17) than the self- referral. In analyses stratified by group, greater quit confidence, quit attempts and Black ethnicity were associated with increased acceptance within the practitioner-referral group. There were no statistically significant interactions between acceptance by referral group and any of the participants' demographic or smoking characteristics.
Among participants in hospital-based lung cancer screening in England who self-reported smoking or met a carbon monoxide cut-off, both practitioner-referral and self-referral smoking cessation strategies were highly accepted. Although self-referral was more frequently accepted, prior evidence suggests practitioner-referrals increase quit attempts, suggesting practitioner-referrals should be the first-line strategy within lung cancer screening, with self-referral offered as an alternative.
在肺癌筛查（LCS）中优化戒烟（SC）转诊策略可以显著降低肺癌死亡率。本研究旨在通过 Lung Screen Uptake Trial 中在医院进行的 LCS 肺部健康检查中，测量参与者对从业者转诊或自我转诊接受 SC 支持的情况。
单盲、双臂随机对照试验。
英格兰。
642 名年龄在 60 至 75 岁之间的个体，他们在肺部健康检查期间自我报告目前吸烟或一氧化碳读数超过 10ppm。
参与者随机（1:1）接受当地戒烟服务（SSS）的联系信息卡进行自我转诊（自我转诊组，n=360）或由护士或试验从业者代表他们进行 SSS 转诊（从业者转诊组，n=329）。
主要结果是接受从业者转诊（定义为参与者允许将他们的详细信息与当地 SSS 共享）与接受自我转诊（定义为参与者将物理 SSS 联系信息卡带到当地 SSS 进行自我转诊）的比较。
有一半（49.8%）接受了从业者对当地 SSS 的转诊，而大多数（88.5%）接受了自我转诊。接受从业者转诊的可能性统计学显著较低（调整后的优势比=0.10；95%置信区间=0.06-0.17），而自我转诊的可能性较高。在按组分层的分析中，更高的戒烟信心、戒烟尝试和黑人种族与从业者转诊组的更高接受率相关。在接受者转诊组和参与者的任何人口统计学或吸烟特征之间没有统计学显著的相互作用。
在英格兰医院进行的肺癌筛查中，自我报告吸烟或符合一氧化碳截止值的参与者中，从业者转诊和自我转诊戒烟策略都得到了高度接受。虽然自我转诊更常被接受，但之前的证据表明，从业者转诊可以增加戒烟尝试，这表明从业者转诊应该是肺癌筛查的首选策略，同时提供自我转诊作为替代方案。
