Research shows that the chances of quitting smoking improve with integrated care, including medication and counseling

According to researchers at the University of Texas MD Anderson Cancer Center, smokers who undergo lung cancer screening may have the best chance of quitting if they receive integrated care, including medication and comprehensive guidance from tobacco treatment specialists.

The research results, published in JAMA Internal Medicineshow that integrated care outperformed other quit methods, with an almost twofold improvement in the odds of quitting.

In this randomized clinical trial of 630 current smokers eligible for lung cancer screening, more than 30% of those receiving integrated care had still not quit smoking after six months.

“For those who smoke, lung cancer screening provides a critical opportunity to support their quitting efforts,” said lead researcher Paul Cincipini, Ph.D., chair of Behavioral Science and executive director of the Tobacco Research and Treatment Program at MD Anderson. .

“Our study shows that providing access to effective medications and trained smoking cessation specialists offers the greatest chance of successfully quitting and, hopefully, avoiding the potential of lung cancer.”

Lung cancer is the leading cause of cancer death in the US and the second most commonly diagnosed cancer, accounting for one in five cancer-related deaths. Tobacco use is responsible for 85% of lung cancer cases and contributes to nearly 30% of all cancer deaths. An estimated 480,000 Americans die each year from tobacco-related diseases.

The average smoker makes several attempts to quit before successfully overcoming the addiction. MD Anderson’s Tobacco Research and Treatment Program addresses barriers to smoking cessation at the individual and population levels, and MD Anderson scientists conduct research designed to transform clinical practice by addressing knowledge gaps among health care providers who treat tobacco dependence.

This study recruited participants from Houston between July 2017 and 2021. They were at least 50 years old and smoked an average of 20 cigarettes per day.

Participants were randomized into three groups of 210 and received the following interventions: a quitline referral and nicotine replacement therapy (NRT) (QL); a stop line referral plus NRT or medication prescribed by a lung cancer screening doctor (QL+); or integrated care (IC), which included NRT or prescription pharmacotherapy and counseling, delivered by a team of tobacco treatment specialists and physicians.

At three months, IC had the highest quit rate, 37.1%, compared to 27.1% in the QL+ and 25.2% in the QL- cohorts. At six months, IC maintained the highest quit rate, 32.4%, compared to 27.6% for the QL+ group and 20.5% for the QL- group.

“Facilities equipped to provide dedicated and integrated care must make this a priority to give patients the best chance for smoking cessation and better health outcomes,” Cincipini said.

“Given our results, it is conceivable that this approach could also be highly effective outside a screening setting, such as post-traumatic stress clinics and in patients with cancer, cardiovascular disease or diabetes.”

Limitations of this study include that the population was predominantly white and the entire sample lacked CO (expired carbon monoxide) abstinence due to COVID restrictions after the study began, although overall results between subsamples with and without verification were similar .