ASPO Abstracts
Lung cancer screening results and changes in smoking behavior reveals subsets of individuals likely to continue or reinitiate smoking
Category: Early Detection & Risk Prediction
Conference Year: 2021
Abstract Body:
PURPOSE: Using data from the National Lung Screening Trial (NLST), we performed a post hoc analysis to
determine if lung cancer screening results are associated with changes in smoking status among participants in
the low-dose computed tomography (LDCT)-arm.
METHODS: Baseline and follow-up demographic, clinical, and smoking-related data was obtained on a subset of
participants (N=6,802). Follow-up smoking data was analyzed after participants received the results of their LDCT
screen (positive screen vs. negative screen result) at three different intervals: baseline (T0), first follow-up (T1),
and second follow-up (T2). Smoking status was defined as current or former and the Fagerstrom Test for Nicotine
Dependence (FTND) score was used to assess nicotine dependency (low, moderate, or high) at T0. Logistic
regression analyses were performed to analyze the association between screening result and smoking status at
follow-up. The data were stratified by smoking status prior to the screen and baseline nicotine dependency.
Demographics were assessed as other potential effect modifiers.
RESULTS: Among current smokers at baseline who were highly nicotine dependent, we found an inverse
association (OR=0.53; 95% CI 0.40-0.72) suggesting current smokers were quitting smoking after receiving their
screening results. At the T1 screening interval, a similar association was found for current smokers who were
highly nicotine dependent, but the point estimate was not statistically significant. Interestingly, highly nicotine
dependent current smokers at the T2 screening interval appeared to be reinitiating smoking (OR=1.45; 95% CI
0.75-2.78) after receiving their screening results. The former smokers at baseline who were highly nicotine
dependent appeared to be reinitiating smoking (OR=1.39; 95% CI 0.86-2.24) after receiving their T0 screening
results and this trend continued at the T1 and T2 screening intervals. We found that pack-years smoked, sex,
race, ethnicity, education, and marital status influenced changes in smoking behavior after the T2 screening
interval.
CONCLUSION: This is one of the first analyses to investigate longitudinal changes in smoking behavior following
the results of lung cancer screening. Our findings highlight the potential value of assessing ni
Keywords: lung cancer, screening, smoking