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Telephone-based counseling after lung cancer screening helps smokers quit

Smokers who undergo lung cancer screening and receive both cessation resources and telephone counseling are more likely to quit than those who receive cessation resources only, according to a study published in Lung Cancer.

If a patient is a candidate for lung cancer screening based on current  U.S. Preventive Task Force guidelines, and wants to pursue that screening, it may be an opportune time to broach the subject of cessation, one of the researchers, Kathryn L. Taylor, PhD, of the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington D.C., told Healio Family Medicine. 

“This is a potential ‘teachable moment’ when patients may be more amenable to making a change in their smoking,” Taylor said. “For the physician making the referral to lung screening, this is a time to use the five As — Ask, Advise, Assess, Assist, Arrange — to offer pharmacotherapy as appropriate, such as nicotine replacement therapy, varenicline and bupropion, and referrals to cessation programs and the national Quitline [network]. Physicians should encourage patients to use the lung screening as a time to make a change in smoking, clearly stating that the single best thing they can do for their health is to quit smoking.”

Taylor and colleagues studied data from 92 smokers aged 50 to 77 years old, registered to undergo lung cancer screening and who had smoked more than 20 pack-years. All of them received contact information for local cessation resources, a text messaging link, Legacy’s BecomeAnEx booklet and website and a link to the Livestrong My Quit App. Half were randomly assigned to also receive six weekly counselor-initiated counseling calls that lasted 15 to 20 minutes.

Taylor and colleagues used intent-to-treat analyses after 3 months of randomization and found that quit rates were 17.4% for those who received telephone counseling and 4.3% for those who did not (P < .05). A nicotine-saliva test verified whether the person had quit smoking.

Providing assistance  to patients who continue to smoke is a critical step doctors should take, Taylor told Healio Family Medicine. She offered additional ways to raise the subject.

“It is very important for primary care physicians to emphasize the importance of stopping smoking with each patient visit. Even when patients are not ready to quit now, let them know that you will continue to ask about it and to offer assistance when they are ready to think more about it,” she said. “Using the five As — Ask, Advise, Assess, Assist, Arrange — with patients who are smoking is [also] effective at helping patients to stop smoking.” 

Based on the study’s promising results, the researchers received NIH funding to replicate their study with a larger group of patients to gauge the effectiveness of telephone-based cessation counseling, according to a press release. – by Janel Miller

Disclosures: The study was funded by the Prevent Cancer Foundation.