Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut.
Yale Cancer Center, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, New Haven, Connecticut.
J Thorac Oncol. 2024 Apr;19(4):643-649. doi: 10.1016/j.jtho.2023.11.012. Epub 2023 Nov 15.
To determine whether personalized gain-framed messaging and biomarker feedback related to tobacco cessation or reduction decrease smoking behavior in patients undergoing or eligible for lung cancer screening.
Between 2016 and 2020, 188 patients were enrolled in a two-phase, sequential, randomized controlled trial. Phase 1 evaluated whether standard of care (SC) (five in-person counseling sessions and 8 weeks of nicotine patch) plus gain-framed messaging (GFM) versus SC would increase 8-week biochemically verified smoking cessation rates. In 143 participants randomized in phase 2, we tested whether feedback on smoking-related biomarkers would reduce 6-month self-reported number of cigarettes smoked per day compared with a no feedback control. Chi-square test and mixed effects repeated measures analyses were used to evaluate group differences.
Participants were 62.5 ± 5.6 (mean ± SD) years of age, had a 50.3 ± 21 pack-year smoking history, and were smoking 16.9 ± 9.9 cigarettes per day. At 8 weeks, there was no difference in quit rates between those randomized to SC plus GFM (n = 15 of 93, 16.1%) and those randomized to SC (n = 16 of 95, 16.8%), with p equals to 0.90. At the 6-month post-randomization follow-up, number of cigarettes smoked per day was similar in the feedback (least-squares mean = 7.5, 95% confidence interval: 6.0-9.1) and no feedback arms (7.7, 95% confidence interval: 6.2-9.3), with p equals to 0.87.
Gain-framed messaging and health feedback did not significantly improve quit rates relative to comprehensive standard of care. Nevertheless, the overall program achieved clinically meaningful smoking quit rates in this older high pack-year cohort, highlighting the importance of intensive tobacco treatment for patients undergoing lung cancer screening. CLINICAL TRIAL REGISTERED WITH CLINICALTRIALS.GOV: NCT02658032.
为了确定与戒烟或减少吸烟相关的个性化收益框架信息和生物标志物反馈是否会降低正在接受或有资格接受肺癌筛查的患者的吸烟行为。
在 2016 年至 2020 年间，共有 188 名患者入组了一项两阶段、序贯、随机对照试验。第 1 阶段评估标准护理（SC）（五次面对面咨询和 8 周尼古丁贴片）加收益框架信息（GFM）是否会增加 8 周生化验证的戒烟率。在第 2 阶段随机分配的 143 名参与者中，我们测试了与吸烟相关的生物标志物反馈是否会减少 6 个月的自我报告每天吸烟量，与无反馈对照组相比。使用卡方检验和混合效应重复测量分析来评估组间差异。
参与者的年龄为 62.5±5.6（均值±标准差）岁，吸烟史为 50.3±21 包年，每天吸烟 16.9±9.9 支。在 8 周时，随机分配到 SC 加 GFM（n=93 中的 15 例，16.1%）和 SC（n=95 中的 16 例，16.8%）的两组之间的戒烟率没有差异，p 等于 0.90。在随机分组后 6 个月的随访中，反馈组（最小二乘均数=7.5，95%置信区间：6.0-9.1）和无反馈组（7.7，95%置信区间：6.2-9.3）的每天吸烟量相似，p 等于 0.87。
与综合标准护理相比，收益框架信息和健康反馈并没有显著提高戒烟率。然而，在这个年龄较大、吸烟量较大的队列中，整个项目实现了有临床意义的戒烟率，突出了对正在接受肺癌筛查的患者进行强化烟草治疗的重要性。临床试验在 CLINICALTRIALS.GOV 注册：NCT02658032。
