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Original research
Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials
  1. Parris J Williams1,2,3,
  2. Keir E J Philip1,
  3. Sara C Buttery1,2,3,
  4. Alexis Perkins1,2,3,
  5. Ley Chan1,2,
  6. Emily C Bartlett2,4,
  7. Anand Devaraj2,4,
  8. Samuel V Kemp2,
  9. James Addis4,
  10. Jane Derbyshire5,
  11. Michelle Chen5,
  12. Michael I Polkey3,
  13. Anthony A Laverty6,
  14. Nicholas S Hopkinson1
  1. 1 National Heart and Lung Institute, Imperial College London, London, UK
  2. 2 Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
  3. 3 NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
  4. 4 Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
  5. 5 West London Cancer Alliance, Royal Marsden Partners, London, UK
  6. 6 Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
  1. Correspondence to Professor Nicholas S Hopkinson, National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK; n.hopkinson{at}


Background Immediate smoking cessation interventions delivered alongside targeted lung health checks (TLHCs) to screen for lung cancer increase self-reported abstinence at 3 months. The impact on longer term, objectively confirmed quit rates remains to be established.

Methods We followed up participants from two clinical trials in people aged 55–75 years who smoked and took part in a TLHC. These randomised participants in the TLHC by day of attendance to either usual care (UC) (signposting to smoking cessation services) or an offer of immediate smoking cessation support including pharmacotherapy. In the QuLIT1 trial, this was delivered face to face and in QuLIT2, it was delivered remotely. Follow-up was conducted 12 months after the TLHC by telephone interview with subsequent biochemical verification of smoking cessation using exhaled CO.

Results 430 people were enrolled initially (115 in QuLIT1 and 315 in QuLIT2), with 4 deaths before 12 months leaving 426 (62.1±5.27 years old and 48% women) participants for analysis. At 12 months, those randomised to attend on smoking cessation support intervention days had higher quit rates compared with UC adjusted for age, gender, deprivation, and which trial they had been in; self-reported 7-day point prevalence (20.0% vs 12.8%; adjusted OR (AOR)=1.78; 95% CI 1.04 to 2.89) and CO-verified quits (12.1% vs 4.7%; AOR=2.97; 95% CI 1.38 to 6.90). Those in the intervention arm were also more likely to report having made a quit attempt (30.2% vs UC 18.5%; AOR 1.90; 95% CI 1.15 to 3.15).

Conclusion Providing immediate smoking cessation support alongside TLHC increases long term, biochemically confirmed smoking abstinence.

Trial registration number ISRCTN12455871.

  • smoking cessation
  • lung cancer
  • tobacco and the lung

Data availability statement

Data are available upon reasonable request. Anonymised research data will be shared with third parties via request to the senior author (NSH).

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Data availability statement

Data are available upon reasonable request. Anonymised research data will be shared with third parties via request to the senior author (NSH).

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  • Twitter @ParrisWilliams1, @keirphilip, @anthonylav, @COPDdoc

  • Contributors NSH, ECB, AD, SVK, JA, JD and MC designed the study. PJW and KEJP conducted follow-up calls, PJW conducted data analysis, supported by AAL and NSH. PJW produced the first draft to which all authors KEJP, SCB, AP, LC, ECB, AD, SVK, JA, JD, MC, MIP, AAL and NSH contributed. All authors have reviewed and approved the final manuscript and NSH is the guarantor.

  • Funding This work was supported by RM Partners, West London Cancer Alliance, hosted by The Royal Marsden NHS Foundation Trust and The Royal Brompton and Harefield Charities.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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