Smoking cessation interventions for potential use in the lung cancer screening setting: A systematic review and meta-analysis

•Many efficacious interventions exist that could be implemented by screening sites.•Cessation estimates are lower than the general population.•Multi-modality interventions appear to be most efficacious.•Cessation persists at 12-months in two intervention categories. Current guidelines recommend deli...

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Published in:	Lung cancer (Amsterdam, Netherlands) Vol. 135; pp. 205 - 216
Main Authors:	Cadham, Christopher J., Jayasekera, Jinani C., Advani, Shailesh M., Fallon, Shelby J., Stephens, Jennifer L., Braithwaite, Dejana, Jeon, Jihyoun, Cao, Pianpian, Levy, David T., Meza, Rafael, Taylor, Kathryn L., Mandelblatt, Jeanne S.
Format:	Journal Article
Language:	English
Published:	Ireland Elsevier B.V 01-09-2019
Subjects:	Counseling Early Intervention, Educational Humans Lung cancer screening Lung Neoplasms - epidemiology Lung Neoplasms - etiology Mass Screening Meta-analysis Odds Ratio Publication Bias Smoking Cessation FDA OR NCCN CMS Lung cancer screening Meta-analysis USPSTF Smoking cessation NELSON NLST SCALE LCS 95% CI
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Summary:	•Many efficacious interventions exist that could be implemented by screening sites.•Cessation estimates are lower than the general population.•Multi-modality interventions appear to be most efficacious.•Cessation persists at 12-months in two intervention categories. Current guidelines recommend delivery of smoking cessation interventions with lung cancer screening (LCS). Unfortunately, there are limited data to guide clinicians and policy-makers in choosing cessation interventions in this setting. Several trials are underway to fill this evidence gap, but results are not expected for several years. We conducted a systematic review and meta-analysis of current literature on the efficacy of smoking cessation interventions among populations eligible for LCS. We searched PubMed, Medline, and PsycINFO for randomized controlled trials of smoking cessation interventions published from 2010–2017. Trials were eligible for inclusion if they sampled individuals likely to be eligible for LCS based on age and smoking history, had sample sizes >100, follow-up of 6- or 12-months, and were based in North America, Western Europe, Australia, or New Zealand. Three investigators independently screened 3,813 abstracts and identified 332 for full-text review. Of these, 85 trials were included and grouped into categories based on the primary intervention: electronic/web-based, in-person counseling, pharmacotherapy, and telephone counseling. At 6-month follow-up, electronic/web-based (odds ratio [OR] 1.14, 95% CI 1.03–1.25), in-person counseling (OR 1.46, 95% CI 1.25–1.70), and pharmacotherapy (OR 1.53, 95% CI 1.33–1.77) interventions significantly increased the odds of abstinence. Telephone counseling increased the odds but did not reach statistical significance (OR 1.21, 95% CI 0.98–1.50). At 12-months, in-person counseling (OR 1.28 95% CI 1.10–1.50) and pharmacotherapy (OR 1.46, 95% CI 1.17–1.84) remained efficacious, although the decrement in efficacy was of similar magnitude across all intervention categories. Several categories of cessation interventions are promising for implementation in the LCS setting.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0169-5002 1872-8332
DOI:	10.1016/j.lungcan.2019.06.024