Intensive telephone-based intervention boosted smoking cessation at 3 months

Immediate provision of an intensive telephone-based smoking cessation intervention was associated with increased rates of smoking cessation at 3 months, researchers reported at the European Respiratory Society International Congress.

Parris Williams, PhD student at the National Heart and Lung Institute (NHLI) Imperial College, London, presented results of the QuLIT2 study, which evaluated whether remote delivery of immediate smoking cessation counseling the medication for people undergoing lung cancer screening is effective for increasing quit rates. It has previously been demonstrated in the QuLIT1 trial that immediate face-to-face smoking cessation support for those undergoing screening was associated with a 29.2% quit rate compared with 11% for those in a control group, Williams said during the presentation.

The single-blind, randomized controlled trial included smokers aged 55 to 75 years who attended a Targeted Lung Health Check. Participants had an initial tele-consultation then chest CT if the risk threshold was reached. Researchers randomly assigned 315 current smokers to the telephone-based smoking cessation intervention (n = 152; mean age, 61.3 years; 44.7% women) or usual care (n = 163; mean age, 63 years; 51.5% women).

The intervention group received six sessions of behavioral support plus pharmacotherapy (varenicline or nicotine replacement therapy). Researchers delivered the intervention between 2 and 48 hours after the initial telephone consultation. The usual care group received very brief advice on smoking cessation with signposting to local cessation services, according to Williams.

The primary outcome was self-reported 7-day smoking abstinence at 3 months.

Overall, 40 patients were lost to follow-up in the intervention group and 48 were lost in the usual care group.

Researchers reported a higher self-reported 7-day point prevalence of smoking abstience among participants in the intervention group than the usual care group (21.1% vs. 8.9%; OR = 2.83; 95% CI, 1.44-5.61; P = .002). In addition, both successful and unsuccessful smoking cessation attempts were more likely among participants in the intervention arm than those in the usual care group (37.5% vs. 22%; OR = 2.11; 95% CI, 1.29-3.47; P = .003).

Participants in the intervention group also had higher use of varenicline (28% vs. 2.7%; OR = 13.65; 95% CI, 1.72-108.24; P = .01), single-item nicotine replacement therapy (21% vs. 5.5%; OR = 4.53; 95% CI, 0.95-21.61; P = .05) and dual-item nicotine replacement therapy (37% vs. 3.8%; OR = 6.41; 95% CI, 1.75-23.51; P = .005). Participants in the usual care group had a higher use of e-cigarettes compared with those in the intervention group (30.5% vs. 14%; OR = 0.37; 95% CI, 0.13-1.04; P = .05).

“The remote cessation interventions are successful at increasing quit rates. It’s slightly less than what we saw with the initial phase of the trial. So, a combination of approaches is likely to be useful in this patient cohort,” Williams said.

“Lung screen settings are effective teachable moments for smoking cessation. Immediacy of the intervention and pharmacotherapy are important in this patient cohort because high nicotine dependents have been smoking for a long time. All lung cancer screening or health check settings really should embed smoking cessation into their programs.”