Strategies to deliver smoking cessation interventions during targeted lung health screening - a systematic review and meta-analysis.

Abstract

Introduction Lung cancer screening presents an important teachable moment to promote smoking cessation, but the most effective strategy to deliver support in this context remains to be established. Methods We undertook a systematic review and meta-analysis of smoking cessation interventions delivered during lung health screening, published prior to 20/07/2022 MEDLINE, PsychINFO, CENTRAL, EMBASE, CINAHL and Scopus databases. Two reviewers screened titles, and abstracts, four reviewed each full text using prespecified criteria, extracted relevant data, assessed risk of bias and confidence in findings using the GRADE criteria. The review was registered prospectively on PROSPERO (CRD42021242431). Results 10 randomised controlled trials (RCT) and 3 observational studies with a control group were identified. Meta-analysis of 9 RCTs demonstrated that smoking cessation interventions delivered during lung screening programmes increased quit rates compared to usual care (OR: 2.01, 95%: 1.49-2.72 p<0.001). 6 RCTs using intensive (>3 behavioural counselling sessions) interventions demonstrated greater quit rates compared to usual care (OR: 2.11, 95% CI 1.53-2.90, p<0.001). A meta-analysis of 2 RCTs found intensive interventions were more effective than non-intensive (OR: 2.07, 95%CI 1.26-3.40 p=0.004), Meta-analysis of 2 RCTs of non-intensive interventions (<2 behavioural counselling sessions or limited to online information audio take-home materials such as pamphlets) did not show a higher quit rate than usual care (OR: 0.90, 95% CI 0.39-2.08 p=0.80). Discussion Moderate quality evidence supports smoking cessation interventions delivered within a lung screening setting compared to usual care, with high-quality evidence that more intensive interventions are likely to be most effective

Competing Interest Statement

PW, KEJP, SMA, AMP, SB & MP have no conflicts of interest to declare, NSH is medical director of Asthma+Lung UK and chair of Action on Smoking and Health, AAL is a trustee of Action on Smoking and Health.

Clinical Protocols

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=242431

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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