Integrated Care Shows Superiority in Smoking Cessation Among Lung Cancer Screening Participants
In a significant study aimed at identifying the most effective smoking cessation intervention within the lung cancer screening (LCS) setting, researchers conducted a randomized clinical trial from July 2017 to June 2022. The trial, based at a hospital in Houston, Texas, involved 630 LCS-eligible current smokers who were divided into three groups: quitline (QL), QL plus (QL+), and integrated care (IC).
- QL Group: Received quitline referral and 12-week nicotine replacement therapy (NRT).
- QL+ Group: Received quitline referral plus 12-week NRT or pharmacotherapy prescribed by the LCS clinician.
- IC Group: Received 12-week NRT or prescription pharmacotherapy and counseling provided by tobacco treatment specialists within the LCS health care environment.
At the 3-month mark, the IC group reported the highest abstinence rate at 37.1%, compared to 27.1% for QL+ and 25.2% for QL. By 6 months, the IC group maintained its lead with a 32.4% abstinence rate, followed by QL+ at 27.6% and QL at 20.5%. Statistical analyses confirmed the superiority of IC over both QL and QL+, with significant odds ratios favoring IC at both time points.
The study concluded that integrated care, which combines medication with intensive counseling, offers the best chance for smoking cessation among participants in a lung cancer screening setting. While IC consistently outperformed the other methods, the reduced difference with QL+ at 6 months suggests that QL+ could be a viable alternative in settings with limited resources.