Dataset Information

National Cancer Institute Smoking Cessation at Lung Examination Trials Brief Report: Baseline Characteristics and Comparison With the U.S. General Population of Lung Cancer Screening-Eligible Patients.

ABSTRACT:

Introduction

The National Cancer Institute Smoking Cessation at Lung Examination (SCALE) Collaboration includes eight clinical trials testing smoking cessation interventions delivered with lung cancer screening (LCS). This investigation compared pooled participant baseline demographic and smoking characteristics of seven SCALE trials to LCS-eligible smokers in three U.S. nationally representative surveys.

Methods

Baseline variables (age, sex, race, ethnicity, education, income, cigarettes per day, and time to the first cigarette) from 3614 smokers enrolled in SCALE trials as of September 2020 were compared with pooled data from the Tobacco Use Supplement-Current Population Survey (2018-2019), National Health Interview Survey (2017-2018), and Population Assessment of Tobacco and Health (wave 4, 2016-2017) using the U.S. Preventive Services Task Force 2013 (N = 4803) and 2021 (N = 8604) LCS eligibility criteria.

Results

SCALE participants have similar average age as the U.S. LCS-eligible smokers using the 2013 criteria but are 2.8 years older using the 2021 criteria (p < 0.001). SCALE has a lower proportion of men, a higher proportion of Blacks, and slightly higher education and income levels than national surveys (p < 0.001). SCALE participants smoke an average of 17.9 cigarettes per day (SD 9.2) compared with 22.4 (SD 9.3) using the 2013 criteria and 19.6 (SD 9.7) using the 2021 criteria (p < 0.001). The distribution of time to the first cigarette differs between SCALE and the national surveys (p < 0.001), but both indicate high levels of nicotine dependence.

Conclusions

SCALE participants smoke slightly less than the LCS-eligible smokers in the general population, perhaps related to socioeconomic status or race. Other demographic variables reveal small but statistically significant differences, likely of limited clinical relevance with respect to tobacco treatment outcomes. SCALE trial results should be applicable to LCS-eligible smokers from the U.S. population.

SUBMITTER: Meza R

PROVIDER: S-EPMC9257405 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:SignificanceIncreased rates of smoking cessation will be essential to maximize the population benefit of low-dose CT screening for lung cancer. The NCI's Smoking Cessation at Lung Examination (SCALE) Collaboration includes eight randomized trials, each assessing evidence-based interventions among smokers undergoing lung cancer screening (LCS). We examined predictors of trial enrollment to improve future outreach efforts for cessation interventions offered to older smokers in this and other clinical settings.MethodsWe included the six SCALE trials that randomized individual participants. We assessed demographics, intervention modalities, LCS site and trial administration characteristics, and reasons for declining.ResultsOf 6285 trial- and LCS-eligible individuals, 3897 (62%) declined and 2388 (38%) enrolled. In multivariable logistic regression analyses, Blacks had higher enrollment rates (OR 1.5, 95% CI 1.2,1.8) compared to Whites. Compared to "NRT Only" trials, those approached for "NRT + prescription medication" trials had higher odds of enrollment (OR 6.1, 95% CI 4.7,7.9). Regarding enrollment methods, trials using "Phone + In Person" methods had higher odds of enrollment (OR 1.6, 95% CI 1.2,1.9) compared to trials using "Phone Only" methods. Some of the reasons for declining enrollment included "too busy" (36.6%), "not ready to quit" (8.2%), "not interested in research" (7.7%), and "not interested in the intervention offered" (6.2%).ConclusionEnrolling smokers in cessation interventions in the LCS setting is a major priority that requires multiple enrollment and intervention modalities. Barriers to enrollment provide insights that can be addressed and applied to future cessation interventions to improve implementation in LCS and other clinical settings with older smokers.ImplicationsWe explored enrollment rates and reasons for declining across six smoking cessation trials in the lung cancer screening setting. Offering multiple accrual methods and pharmacotherapy options predicted increased enrollment across trials. Enrollment rates were also greater among Blacks compared to Whites. The findings offer practical information for the implementation of cessation trials and interventions in the lung cancer screening context and other clinical settings, regarding intervention modalities that may be most appealing to older, long-term smokers.

Project description:IntroductionThere is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible.MethodsThirty-one lung cancer screening eligible individuals aged 55-80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual telephone interviews were conducted. Data were analysed using the framework approach to thematic analysis.ResultsThree themes were generated: (1) bringing lung cancer closer to home, where screening was viewed as providing an opportunity to motivate smoking cessation, depending on perceived personal risk and screening result; (2) a sensitive approach to cessation with the uptake of cessation support considered to be largely dependent on screening practitioners' communication style and expectations of stigma and (3) creating an equitable service that focuses on ease of access as a key determinant of uptake, where integrating cessation within the screening appointment may sustain increased quit motivation and prevent loss to follow-up.ConclusionsThe integration of smoking cessation into lung cancer screening was viewed positively by those eligible to attend. Screening appointments providing personalized lung health information may increase cessation motivation. Services should proactively support participants with possible fatalistic views regarding risk and decreased cessation motivation upon receiving a good screening result. To increase engagement in cessation, services need to be person-centred.Patient or public contributionThis study has included patient and public involvement throughout, including input regarding study design, research materials, recruitment strategies and research summaries.

Project description:BackgroundLung cancer is one of the most common causes of death from cancer worldwide. Smoking induces and aggravates many health problems, including vascular diseases, respiratory illnesses and cancers. Tobacco smoking constitutes the most important risk factor for lung cancer. Most people with lung cancer are still active smokers at diagnosis or frequently relapse after smoking cessation. Quitting smoking is the most effective way for smokers to reduce the risk of premature death and disability. People with lung cancer may benefit from stopping smoking. Whether smoking cessation interventions are effective for people with lung cancer and whether one method of quitting is more effective than any other has not been systematically reviewed.ObjectivesTo determine the effectiveness of smoking cessation programmes for people with lung cancer.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (accessed via PubMed) and Embase up to 22 December 2018. We also searched the American Society of Clinical Oncology (ASCO) Annual Meeting proceedings, the lung cancer sections of the proceedings of the ESMO Congress, the lung cancer sections of the proceedings of the European Conference of Clinical Oncology (ECCO) Congress, the World Conference on Lung Cancer proceedings, the Society for Research on Nicotine and Tobacco Annual Meeting from 2013, the Food and Drug Administration website, the European Medicine Agency for drug registration website, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal, ClinicalTrials.gov, and the metaRegister of Controlled Trials (mRCT) to 30 December 2018. We applied no restriction on language of publication.Selection criteriaWe planned to include any randomised controlled trial (RCT) of any psychosocial or pharmacological smoking cessation intervention or combinations of both, compared with no intervention, a different psychosocial or pharmacological (or both) intervention or placebo for pharmacological interventions in people with lung cancer.Data collection and analysisTwo review authors independently screened the studies from the initial search for potential trials for inclusion. We planned to use standard methodological procedures expected by Cochrane. We found no trials that met the inclusion criteria.Main resultsWe identified no RCTs that met our inclusion criteria. Among the 1817 records retrieved using our search strategy, we retrieved 19 studies for further investigation. We excluded 15 trials: ten trials because we could not distinguish people with lung cancer from the other participants, or the participants were not people with lung cancer, four because they were not randomised, or RCTs. We excluded one trial because, though it was completed in 2004, no results are available. We assessed four ongoing trials for inclusion when data become available.Authors' conclusionsThere were no RCTs that determined the effectiveness of any type of smoking cessation programme for people with lung cancer. There was insufficient evidence to determine whether smoking cessation interventions are effective for people with lung cancer and whether one programme is more effective than any other. People with lung cancer should be encouraged to quit smoking and offered smoking cessation interventions. However, due to the lack of RCTs, the efficacy of smoking cessation interventions for people with lung cancer cannot be evaluated and concluded. This systematic review identified a need for RCTs to explore these.