Immediate smoking cessation support versus usual care in smokers attending a targeted lung health check: the QuLIT trial

Sara C Buttery, Parris Williams, Rebecca Mweseli, Keir Elmslie James Philip, Ahmed Sadaka, Emily Jade Bartlett, Anand Devaraj, Samual Kemp, Jamie Addis, Jane Derbyshire, Michelle Chen, Katie Morris, Anthony Laverty, Nicholas S Hopkinson, Sara C Buttery, Parris Williams, Rebecca Mweseli, Keir Elmslie James Philip, Ahmed Sadaka, Emily Jade Bartlett, Anand Devaraj, Samual Kemp, Jamie Addis, Jane Derbyshire, Michelle Chen, Katie Morris, Anthony Laverty, Nicholas S Hopkinson

Abstract

Objectives: Lung cancer screening programmes offer an opportunity to address tobacco dependence in current smokers. The effectiveness of different approaches to smoking cessation in this context has not yet been established. We investigated if immediate smoking cessation support, including pharmacotherapy, offered as part of a lung cancer screening programme, increases quit rates compared to usual care (Very Brief Advice to quit and signposting to smoking cessation services).

Materials and methods: We conducted a single-blind randomised controlled trial of current smokers aged 55-75 years attending a Targeted Lung Health Check. On randomly allocated days smokers received either (1) immediate support from a trained smoking cessation counsellor with appropriate pharmacotherapy or (2) usual care. The primary outcome was self-reported quit rate at 3 months. We performed thematic analysis of participant interview responses.

Results: Of 412 people attending between January and March 2020, 115 (27.9%) were current smokers; 46% female, mean (SD) 62.4 (5.3) years. Follow-up data were available for 84 smokers. At 3 months, quit rates in the intervention group were higher 14/48 (29.2%) vs 4/36 (11%) (χ2 3.98, p=0.04). Participant interviews revealed four smoking-cessation related themes: (1) stress and anxiety, (2) impact of the COVID-19 pandemic, (3) CT scans influencing desire to quit and (4) individual beliefs about stopping smoking.

Conclusion: The provision of immediate smoking cessation support is associated with a substantial increase in quit rates at 3 months. Further research is needed to investigate longer-term outcomes and to refine future service delivery.

Trial registration number: ISRCTN12455871.

Keywords: imaging/CT MRI etc; lung cancer; tobacco and the lung.

Conflict of interest statement

Competing interests: NSH is Chair of Action on Smoking and Health and Medical Director of The British Lung Foundation.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flow diagram to represent the flow of patients through the QuLIT trial. QuLIT, Quit Smoking Lung Health Intervention Trial; TLHC, Targeted Lung Health Check.
Figure 2
Figure 2
Thematic map: individual experiences of smoking cessation during the targeted lung health check programme. A thematic map displaying the main four themes, sub themes and relationships. TLHC, Targeted Lung Health Check.

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