Remote Smoking Cessation Program for Individuals Targeted for Lung Screening

A telephone-based smoking cessation intervention for individuals already targeted for lung cancer screening can successfully reduce smoking after 3 months, according to findings of the United Kingdom Quit Smoking Lung Intervention Trial 2 (QuLIT-2), published in Chest.

People who smoke who attend lung cancer screening programs may be predisposed to quit smoking. Support is often necessary, and immediate face-to-face smoking cessation support has been effective. In the UK, researchers for the QuLIT-1 trial previously demonstrated the effectiveness of an in-person smoking cessation intervention for adults enrolled in the UK’s Targeted Lung Health Check (TLHC), a lung cancer screening program targeting adults who smoke and have additional lung cancer risk factors. After the COVID-19 pandemic curtailed this in-person intervention, the researchers conducted QuLIT-2 to determine the effectiveness of a similar remote telephone-based smoking cessation intervention.

The researchers initiated a single-blind randomized controlled trial that included 315 participants in a TLHC screening program, aged 55 to 75, who identified as smokers (mean age 63±5.4 years; 48% women, 85% White). Participants were randomized into either an intervention cohort receiving immediate telephone smoking cessation support cohort lasting for 6 weeks (n=152) or a usual care (UC) cohort (n=163) receiving brief advice to quit and signposting for smoking cessation support services. The primary endpoint at 3 months was self-reported 7-day smoking abstinence (ie, no reported smoking or use of other tobacco product within the past 7 days).

The intervention and UC cohorts were matched at baseline. Participants’ first call was the day of their initial TLHC screening appointment. During this call, they were offered 6 additional behavioral counseling support sessions via telephone along with varenicline or nicotine replacement therapy.

After 3 months, self-reported quit rates using logistic regression were better in the smoking cessation support cohort (21.1%) vs the UC cohort (8.9%) (odds ration [OR] 2.83; 95% CI, 1.44-5.61; P =.002). The effectiveness of the intervention remained consistent when reassessed, controlling for baseline smoking characteristics, participant demographics, and the discovery of abnormalities on low dose CT scan. Researchers also noted that their results suggested that pharmacotherapy was an important component of the smoking cessation intervention.

Trial limitations include self-reported 7-day smoking abstinence vs biochemically confirmed quit rates, the preponderance of White participants, and the high loss to follow-up.

The researchers concluded that “the provision of smoking cessation support including counselling support and pharmacotherapy, delivered by telephone immediately following attendance at a targeted lung health check, significantly increased 7-day point prevalence smoking abstinence at 3 months, compared to usual care.” This remote intervention allows for the added benefit of expanding general access to geographically remote and low-income areas, particularly as the COVID-19 pandemic continues, the researchers noted.

Reference

Williams PJ, Philip KE, Gill NK, et al. Immediate, remote smoking cessation intervention in participants undergoing a targeted lung health check: QuLIT2 a randomised controlled trial. Chest. Published online August 3, 2022. doi:10.1016/j.chest.2022.06.048