2024 World Conference on Lung Cancer (WCLC) - Posters-P2.04A.05 Providing Tobacco Treatment to Patients Undergoing Lung Cancer Screening at a Large U.S. Health System: A Randomized Trial

P2.04A.05 Providing Tobacco Treatment to Patients Undergoing Lung Cancer Screening at a Large U.S. Health System: A Randomized Trial

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The document describes a randomized trial focused on integrating tobacco treatment with lung cancer screening at MedStar Health, a large and diverse health system in the U.S. Mid-Atlantic region. The purpose of the study is to test the effectiveness of two smoking cessation interventions within the context of lung cancer screening. The trial aims to determine if combining tobacco treatment with lung cancer screenings can decrease lung cancer deaths and increase life-years compared to screenings alone.<br /><br />The study addresses barriers to accessing tobacco treatment, such as limited reach and the inequitable distribution of treatment options, through strategies like decentralized interventions and an "opt-out" recruitment approach via electronic health records (EHR). The trial involves an initial randomization of patients, who are smokers undergoing screening, into two groups: one getting e-referrals to a Tobacco Quitline and the other receiving a centralized phone-based nicotine replacement therapy (NRT) intervention from tobacco treatment specialists at MedStar.<br /><br />Patients not abstinent at a 3-month evaluation are re-randomized to either continue with coaching and NRT or receive additional interventions like varenicline or bupropion. Those who achieve abstinence receive further coaching to prevent relapse. The trial's primary outcome is bioverified abstinence from smoking at six months post-randomization, while secondary outcomes include self-reported smoking status, quit attempts, and sustained abstinence.<br /><br />The trial not only aims to improve the uptake of cessation treatments in practice but also to conduct an economic analysis on cost-effectiveness and scalability for broader health system applications. The innovative use of the EHR and pragmatic trial design enhance the study’s potential impact on public health by making tobacco treatment more accessible and integrated within standard healthcare procedures.

Asset Subtitle

Kathryn Taylor

Meta Tag

Speaker Kathryn Taylor

Topic Screening & Early Detection

Keywords

randomized trial

tobacco treatment

lung cancer screening

MedStar Health

smoking cessation

electronic health records

nicotine replacement therapy

bioverified abstinence

cost-effectiveness

public health impact