Immediate, Remote Smoking Cessation Intervention in Participants Undergoing a Targeted Lung Health Check: Quit Smoking Lung Health Intervention Trial, a Randomized Controlled Trial

Parris J Williams, Keir E J Philip, Navjot Kaur Gill, Deirdre Flannery, Sara Buttery, Emily C Bartlett, Anand Devaraj, Samuel V Kemp, Jamie Addis, Jane Derbyshire, Michelle Chen, Katie Morris, Anthony A Laverty, Nicholas S Hopkinson, Parris J Williams, Keir E J Philip, Navjot Kaur Gill, Deirdre Flannery, Sara Buttery, Emily C Bartlett, Anand Devaraj, Samuel V Kemp, Jamie Addis, Jane Derbyshire, Michelle Chen, Katie Morris, Anthony A Laverty, Nicholas S Hopkinson

Abstract

Background: 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.

Research question: 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)?

Study design and methods: 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.

Results: 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.

Interpretation: 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.

Trial registry: ISRCTN registry; No.: ISRCTN12455871; URL: www.IRSCN.com.

Keywords: behavior change; lung cancer; randomized controlled trial; screening; smoking cessation.

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Figures

Graphical abstract
Graphical abstract
Figure 1
Figure 1
Diagram demonstrating the flow of patients through the trial. TLHC = targeted lung health check; TSI = telephone smoking cessation intervention; UC = usual care.
Figure 2
Figure 2
Bar graph showing smoking cessation in the intervention and control arms

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