ASPO Abstracts
Systematic Review and Meta-Analysis of Smoking Cessation Interventions for Potential Use in Lung Cancer Screening Settings: 6- and 12-Month Outcomes
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2019
Abstract Body:
Purpose: The Centers for Medicare and Medicaid Services mandate smoking cessation interventions for individuals at high-risk of lung cancer attending lung screening. These individuals include smokers between ages of 55-77 with >30 pack year history of smoking. However, there is limited evidence on cessation intervention effects in this setting. To address this, we conducted a systematic review and meta-analysis of smoking cessation interventions with potential for use in the setting of lung cancer screening.Methods: We searched Medline, PubMed, and PsycINFO for randomized controlled trials of smoking cessation interventions from 2010-2018. We included trials with participants ages 50+ and heavy smokers. The primary outcome was self-reported or biochemically verified 7-day point prevalence abstinence at 6-months; we also examined 12-month abstinence. Interventions were grouped based on their primary focus: pharmacotherapy, telephone counseling, in-person counseling and electronic/web-based smoking cessation; however, most interventions were multi-modality. Random effects models were used to estimate pooled effect sizes by intervention category.Results: Of the 3814 potentially eligible studies, the final sample included 84 trials (74 with 6-month outcomes; 39 with 12-month outcomes). At 6-months, use of pharmacotherapy (odds ratio [OR] 1.53, 95% CI 1.33-1.77), electronic/web-based (OR 1.14, 95% CI 1.03-1.27), in-person counseling (OR 1.44, 95% CI 1.24-1.67), and telephone counseling (OR 1.20, 95% CI 1.00-1.45) all increased the odds of abstinence. However, at 12-months, only pharmacotherapy (OR=1.46, 95% CI 1.17-1.84) and in-person counseling (OR=1.26, 95% CI 1.06-1.48) remained effective. Telephone counseling and electronic/web-based interventions were no longer effective at 12-months (OR 1.08, 95% CI 0.95-1.24 and OR 1.02, 95% CI 0.89-1.18, respectively).Conclusions: Several categories of interventions appear to be effective at increasing cessation rates among individuals that may be eligible for lung cancer screening, but long-term effectiveness is unclear. Decisions about which strategies to implement should consider results of NCI’s ongoing SCALE trials in lung screening populations, as well as feasibility, costs, and impact on population mortality.
Keywords: Smoking cessation; Meta-analysis; Lung cancer screening