Predictors of cessation readiness among cigarette smokers presenting for low-dose computed tomography lung cancer screening in community settings (WF-20817CD).

BACKGROUND

To plan cessation services and advance health equity, understanding factors related to cessation readiness and differences among patients presenting for lung cancer screening (LCS) is imperative.

METHODS

We recruited smoking patients aged 55-77 years presenting for LCS in 26 community-based imaging clinics participating in an NCI Community Oncology Research Program (NCORP) site-randomized trial (WF-20817CD, UG1CA189824). We collected outcomes of smoking cessation readiness to change and quitting self-efficacy immediately prior to screening. Linear mixed models were constructed with site random effects to assess associations of outcomes and baseline characteristics.

RESULTS

Participants (N=1,094; age=63.7; 81.9% White, 13.3% Black, 2.6% Hispanic, 2.3% American Indian; 20.2% non-metro) were even by gender (50.8% women) and educational attainment (51.1% ≤ high school education). Participants smoked an average of 17.2 cigarettes per day (SD=9.6), with mean pack year of 46.1 (SD=25.0). Predictors of increased cessation readiness included: being a man, increased worry about lung cancer, increased perceived benefits of quitting, quit attempt within past year, and smoking ≤ 10 cigarettes per day. For increased quitting self-efficacy: non-white race/ethnicity, men, less education, no use of other tobacco products, increased perceived benefits of quitting, quit attempt within past year, and smoking ≤ 10 cigarettes per day.

CONCLUSIONS

To support cessation among patients undergoing LCS, imaging clinics and health systems should recognize pre-screening readiness to quit varies by population subgroups. Imaging clinics may benefit from a tailored approach that works with patients "where they are."

IMPACT

These findings suggest that gender, race and ethnicity are associated with smoking cessation readiness and quitting self-efficacy.