Smoking cessation interventions within the context of Low-Dose Computed Tomography lung cancer screening: A systematic review

Bárbara Piñeiro; Vani N Simmons; Amanda M Palmer; John B Correa; Thomas H Brandon

doi:10.1016/j.lungcan.2016.05.028

Smoking cessation interventions within the context of Low-Dose Computed Tomography lung cancer screening: A systematic review

Lung Cancer. 2016 Aug:98:91-98. doi: 10.1016/j.lungcan.2016.05.028. Epub 2016 Jun 1.

Authors

Bárbara Piñeiro¹, Vani N Simmons², Amanda M Palmer³, John B Correa³, Thomas H Brandon²

Affiliations

¹ Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Galicia, Spain. Electronic address: barbara.pineiro@usc.es.
² Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
³ Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA.

PMID: 27393513
DOI: 10.1016/j.lungcan.2016.05.028

Abstract

The integration of smoking cessation interventions (SCIs) within the context of lung cancer screening programs is strongly recommended by screening guidelines, and is a requirement for Medicare coverage of screening in the US. In Europe, there are no lung cancer screening guidelines, however, research trials are ongoing, and prominent professional societies have begun to recommend lung cancer screening. Little is known about the types and efficacy of SCIs among patients receiving low-dose computed tomography (LDCT) screening. This review addresses this gap. Based on a systematic search, we identified six empirical studies published prior to July 1, 2015, that met inclusion criteria for our review: English language, SCI for LDCT patients, and reported smoking-related outcomes. Three randomized studies and three single-arm studies were identified. Two randomized controlled trials (RCTs) evaluated self-help SCIs, whereas one pilot RCT evaluated the timing (before or after the LDCT scan) of a combined (counseling and pharmacotherapy) SCI. Among the single-arm trials, two observational studies evaluated the efficacy of combined SCI, and one retrospectively assessed the efficacy of clinician-delivered smoking assessment, advice, and assistance. Given the limited research to date, and particularly the lack of studies reporting results from RCTs, assumptions that SCIs would be effective among this population should be made with caution. Findings from this review suggest that participation in a lung screening trial promotes smoking cessation and may represent a teachable moment to quit smoking. Findings also suggest that providers can take advantage of this potentially teachable moment, and that SCIs have been successfully implemented in screening settings. Continued systematic and methodologically sound research in this area will help improve the knowledge base and implementation of interventions for this population of smokers at risk for chronic disease.

Keywords: Intervention; Low-Dose Computed Tomography; Lung cancer screening; Smoking cessation; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Early Detection of Cancer / methods
Humans
Lung Neoplasms / diagnostic imaging*
Lung Neoplasms / epidemiology
Lung Neoplasms / prevention & control*
Mass Screening
Odds Ratio
Randomized Controlled Trials as Topic
Smoking Cessation* / methods
Tomography, X-Ray Computed* / methods