Implementing effective tobacco cessation programs within LDCT lung cancer screening is needed as quitting smoking increases life expectancy, decreases risk of competing causes of death, improves length of survival among lung cancer patients, and maximizes the cost-effectiveness of lung cancer screening. Our research team, including experts in smoking cessation, lung cancer screening, and implementation science, will: (1) evaluate a multi-faceted training program to improve short-term smoking cessation rates and sustained abstinence among 1,114 patients who present for LDCT lung cancer screening in 22 community-based practices using a cluster, randomized control trial design; (2) characterize the adoption and adaptation of evidence-based tobacco cessation strategies within community-based LDCT lung cancer screening programs using extensive qualitative data, including analysis of strategic planning documents, a team blog and performance coaching notes, key informant interviews, and observational data; and (3) develop and evaluate an implementation toolkit that explains how to integrate evidence-based tobacco cessation strategies in community-based LDCT lung cancer screening programs in absence of the research team. The majority of lung cancer screening will occur in non-academic, community-based settings with diverse patient populations who are at high risk for lung cancer and other smoking-related illnesses. This effectiveness-implementation hybrid design is intended to promote the rapid translation of the evidence-based tobacco cessation strategies into community-based practices offering LDCT lung cancer screening to reduce smoking-related morbidity and mortality.

Public Health Relevance

This study will promote the rapid translation of the evidence-based tobacco cessation strategies into community-based practices offering low-dose computed tomography (LDCT) lung cancer screening to reduce smoking-related morbidity and mortality. The research team will evaluate a multi-faceted training program to improve short-term smoking cessation rates and sustained abstinence among smoker patients who present for lung cancer screening, characterize the adoption and adaptation of the evidence-based tobacco cessation strategies among 22 community-based LDCT lung cancer screening programs, and develop a plan to disseminate a toolkit that will guide other community-based lung cancer screening programs on integrating smoking cessation services within the context of screening. With an estimated 8.7 million US adults eligible for LDCT lung cancer screening, about half of whom currently smoke, the potential for improving the risk-benefit ratio of lung cancer screening is significant.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA207158-04
Application #
9770825
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Land, Stephanie R
Project Start
2016-09-01
Project End
2021-08-31
Budget Start
2019-09-01
Budget End
2020-08-31
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Wake Forest University Health Sciences
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
937727907
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157
Joseph, Anne M; Rothman, Alexander J; Almirall, Daniel et al. (2018) Lung Cancer Screening and Smoking Cessation Clinical Trials. SCALE (Smoking Cessation within the Context of Lung Cancer Screening) Collaboration. Am J Respir Crit Care Med 197:172-182