Dressler Emily V, Weaver Kathryn E, Sutfin Erin L, Bellinger Christina, Miller David P, Falk Derek, Petty W Jeffrey, Spangler John, Stone Rebecca, Kittel Carol, Lesser Glenn J, Chiles Caroline, Lewis Jennifer A, Long Foley Kristie
Wake Forest University School of Medicine, Winston Salem, NC, United States.
Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States.
Cancer Epidemiol Biomarkers Prev. 2025 Jul 22. doi: 10.1158/1055-9965.EPI-25-0293.
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.
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.
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.
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."
These findings suggest that gender, race and ethnicity are associated with smoking cessation readiness and quitting self-efficacy.
为了规划戒烟服务并促进健康公平，了解与戒烟意愿相关的因素以及肺癌筛查（LCS）患者之间的差异至关重要。
我们招募了年龄在55 - 77岁、前往26家参与美国国立癌症研究所（NCI）社区肿瘤研究项目（NCORP）站点随机试验（WF - 20817CD，UG1CA189824）的社区影像诊所进行LCS的吸烟患者。我们在筛查前立即收集了戒烟意愿改变和戒烟自我效能的结果。构建了具有站点随机效应的线性混合模型，以评估结果与基线特征之间的关联。
参与者（N = 1,094；年龄 = 63.7岁；81.9%为白人，13.3%为黑人，2.6%为西班牙裔，2.3%为美国印第安人；20.2%来自非都市地区）在性别（50.8%为女性）和教育程度（51.1% ≤ 高中教育）方面分布均匀。参与者平均每天吸烟17.2支（标准差 = 9.6），平均吸烟包年数为46.1（标准差 = 25.0）。戒烟意愿增加的预测因素包括：男性、对肺癌的担忧增加、对戒烟益处的认知增加、过去一年内有戒烟尝试以及每天吸烟≤10支。对于戒烟自我效能增加：非白人种族/族裔、男性、教育程度较低、不使用其他烟草制品、对戒烟益处的认知增加、过去一年内有戒烟尝试以及每天吸烟≤10支。
为了支持接受LCS的患者戒烟，影像诊所和卫生系统应认识到筛查前的戒烟意愿因人群亚组而异。影像诊所可能会从与患者“在其现有状态”合作的定制方法中受益。
这些发现表明，性别、种族和族裔与戒烟意愿和戒烟自我效能相关。
