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Lung cancer
Original article
Impact of low-dose CT screening on smoking cessation among high-risk participants in the UK Lung Cancer Screening Trial
  1. Kate Brain1,
  2. Ben Carter1,2,
  3. Kate J Lifford1,
  4. Olivia Burke1,
  5. Anand Devaraj3,
  6. David R Baldwin4,
  7. Stephen Duffy5,
  8. John K Field6
  1. 1Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
  2. 2Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
  3. 3Royal Brompton and Harefield NHS Trust, London, UK
  4. 4Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
  5. 5Queen Mary University of London, London, UK
  6. 6Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
  1. Correspondence to Dr Kate Brain, Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS, UK; brainke{at}cardiff.ac.uk

Abstract

Background Smoking cessation was examined among high-risk participants in the UK Lung Cancer Screening (UKLS) Pilot Trial of low-dose CT screening.

Methods High-risk individuals aged 50–75 years who completed baseline questionnaires were randomised to CT screening (intervention) or usual care (no screening control). Smoking habit was determined at baseline using self-report. Smokers were asked whether they had quit smoking since joining UKLS at T1 (2 weeks after baseline scan results or control assignment) and T2 (up to 2 years after recruitment). Intention-to-treat (ITT) regression analyses were undertaken, adjusting for baseline lung cancer distress, trial site and sociodemographic variables.

Results Of a total 4055 individuals randomised to CT screening or control, 1546 were baseline smokers (759 intervention, 787 control). Smoking cessation rates were 8% (control n=36/479) versus 14% (intervention n=75/527) at T1 and 21% (control n=79/377) versus 24% (intervention n=115/488) at T2. ITT analyses indicated that the odds of quitting among screened participants were significantly higher at T1 (adjusted OR (aOR) 2.38, 95% CI 1.56 to 3.64, p<0.001) and T2 (aOR 1.60, 95% CI 1.17 to 2.18, p=0.003) compared with control. Intervention participants who needed additional clinical investigation were more likely to quit in the longer term compared with the control group (aOR 2.29, 95% CI 1.62 to 3.22, p=0.007) and those receiving a negative result (aOR 2.43, 95% CI 1.54 to 3.84, p<0.001).

Conclusions CT lung cancer screening for high-risk participants presents a teachable moment for smoking cessation, especially among those who receive a positive scan result. Further behavioural research is needed to evaluate optimal strategies for integrating smoking cessation intervention with stratified lung cancer screening.

Trial registration number Results, ISRCTN 78513845

  • Lung Cancer
  • Smoking cessation

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/thoraxjnl-2016-209690

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    Footnotes

    • Twitter Follow Kate Brain @Katebrain

    • Contributors KB—trial conception and design, data analysis, data interpretation, manuscript preparation. BC—trial statistician, statistical analysis, data interpretation, manuscript review. KJL—data collection, data analysis, data interpretation, manuscript review. OB—data analysis and interpretation, manuscript review. AD—radiological review, data interpretation and manuscript review. DRB—trial design, UKLS care pathway, data interpretation, manuscript review. SD—trial design, data interpretation, manuscript review. JKF—trial conception and design, data interpretation, manuscript review.

    • Funding NIHR Health Technology Assessment (HTA) programme. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of NIHR HTA, National Health Service or the Department of Health.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Ethical approval for the study was given by Liverpool Central research ethics committee in December 2010 (reference number 10/H1005/74). All UKLS participants provided informed consent before taking part. The trial was registered with the International Standard Randomised Controlled Trial Register (ISRCTN) under the reference 78513845.

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

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