Smoking is the leading cause of preventable disease and pre-mature death worldwide. Two of the most common diseases caused by smoking are lung cancer and chronic obstructive pulmonary disorder (COPD). Around 86% of all lung cancers and 90% of COPD cases are attributable to smoking and as such there is a great incentive to fund smoking cessation programs in an effort to improve health and reduce overall health care costs. Smoking cessation programs around the world include methods that target the packaging and advertising of cigarettes as well as programs that help the smoker quit. Recently, a clinical trial to determine the effectiveness of low-dose CT scans in early detection of lung cancer has questioned whether a clean scan may give people a ‘license to smoke’ or a feeling of invincibility. To understand the impact of low-dose CT scans on smoking cessation patterns, a team of researchers from the UK surveyed over 1500 people in the UK Lung Cancer Screening trial.
A total of 1546 baseline smokers were randomized into two groups, the intervention group given low-dose CT scans to screen for cancer, and the control group, given standard care from a physician. Subjects were asked whether they had quit smoking on short term follow up (2 weeks after CT scan) or long term follow up (up to 2 years). In the control group, 5% of individuals quit smoking and in the intervention group 10% quit smoking 2 weeks after the CT scan. After 2 years, 10% of the control group had quit smoking while 15% of the intervention group had quit. This equated to a 2.38 times greater likelihood of quitting smoking in the weeks after a CT scan and a 1.6 times greater likelihood of quitting smoking in the years following the scan. For individuals who needed additional clinical investigation for the lung cancer status they were more likely to quit smoking in the long term than the control group (2.29 times more likely 2 years after).
These results highlight the importance of teaching while screening for cancer in high risk individuals. Those who had the CT scan regardless of the diagnosis were more likely to try to quit smoking than those who did not receive the scan. In people who unfortunately had a positive cancer screen this likelihood of quitting was even higher. It is not likely that CT scans will become a tool used in the smoking cessation campaign but we can begin to educate smokers at risk for lung cancer at every stage of their treatment. Additionally, screening for lung cancer does not seem to negatively impact a person’s desire to quit smoking regardless of if the test is negative. Integrating smoking cessation programs into standard care for lung cancer and COPD could be an effective way of increasing smoking cessation and reducing smoking mortality and disease.
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