Counseling May Result in Higher Rates of Smoking Cessation

Patients who received phone counseling were more likely to quit smoking than patients who received a list of low cost services.

New findings suggest that smoking cessation counseling following a lung cancer screening may be an effective approach to help individuals stop smoking.

"We found that at this teachable moment -- a time when smokers are thinking about their health and may be ready to make a change -- offering help makes a difference, and may help save lives," said lead study researcher, Kathryn L. Taylor, PhD.

Included in a study published by Lung Cancer were 92 patients who smoked at baseline. The study was conducted at MedStar Georgetown University Hospital, Hackensack University Medical Center, and Lahey Hospital and Medical Center.

"Millions of current smokers are now eligible for lung cancer screening, so this setting represents an important opportunity to exert a large public health impact on cessation among smokers who are at very high risk for multiple tobacco-related disorders," Dr Taylor said. "This is a great way to engage smokers who have not sought out cessation help."

The findings were so significant that the researchers were awarded a grant from the National Institutes of Health (NIH) to conduct a larger study that will enroll 1300 patients receiving screenings at 5 different medical centers.

The US Preventive Service Task Force suggests that individuals who accumulate 30 pack-years (smoking 1 pay per day for 30 years or 2 packs per day for 15 years) should receive an annual low-dose CT lung cancer screening.

The American Lung Association reported that nearly 160,000 Americans were estimated to die in 2016 from lung cancer alone, making it a leading killer. Under the Affordable Care Act, most smoking patients are eligible for the test without cost sharing, with the hopes of diagnosing and treating patients early.

In the new study, the patients agreed to receive phone counseling or standard of care, which included a list of free and less costly smoking cessation resources. After participants underwent screening, they were randomized to receive 1 of the 2 interventions.

Each group had the same number of patients with abnormal findings, such as precancerous lesions of COPD, according to the study. Both groups also included the same number of patients with minor abnormalities and normal results. At baseline, no patients were diagnosed with lung cancer.

Patients in the telephone counseling group started their sessions after finding out their test results, and received 6 additional sessions. At the conclusion of the study, participants who said they quit smoking were given a nicotine saliva for confirmation.

The investigators found that 17% of participants in the telephone counseling group quit smoking, while only 4% of patients in the standard care group quit, according to the study.

"If this preliminary study is replicated, telephone counseling has the potential to improve cessation in a setting that reaches a large number of hard-to-reach, long-term smokers who are at very high risk for multiple tobacco-related diseases," Dr Taylor said.

The authors said that telephone counseling was able to provide patients with motivation that the standard of care did not.

“Everyone acknowledged that smoking is very harmful to their health, but some people thought it was too late to change their fate. Counseling helped them understand that it is not too late,” said researcher Charlotte Hagerman, who was trained as a tobacco treatment specialist for the study.

Other studies have shown that older smokers who quit increase their life expectancy. The investigators also discovered that a lot of participants were ready to quit and receptive of the information being given over the phone, which suggests that counseling can reach individuals who may not be ready to quit on their own, according to the study.

"More than 50% of participants said in their first interview that they were not ready to quit, yet some of these people did quit. This finding indicates that it is important to offer the cessation intervention to everyone who undergoes lung cancer screening, and not only those who are already considering quitting," Dr Taylor concluded. “This is exactly what we hope for -- to be able to reach the people who are not already planning to quit on their own.”