Oncology Rounds

Smoking kills. Can telephone-based cessation counseling help?

by Deirdre Saulet and Ashley Riley

When the USPSTF in 2013 recommended low-dose CT screening for patients at high risk for lung cancer, organizations across the country started investing in lung cancer screening programs—a critical component of which is smoking cessation counseling. Unfortunately, limited resources and logistical barriers for patients often make it difficult to deliver effective smoking cessation counseling.

Could telehealth be the solution? Keep reading to find out.

What did a randomized control trial say?

Researchers at the Georgetown Lombardi Comprehensive Cancer Center conducted a randomized control trial to test the feasibility and efficacy of a telephone-counseling smoking cessation intervention compared to usual care for lung cancer screening patients. They enrolled patients from three different sites on the East Coast—MedStar Georgetown University Hospital in Washington, D.C., Hackensack University Medical Center in New Jersey, and Lahey Hospital and Medical Center in Massachusetts. Participants included current smokers registered to receive lung cancer screening, aged 50-77 years old, who had more than 20 years smoking history.

After receiving their screening results, patients in the telephone-counseling smoking cessation group (n=46) received a list of evidence-based smoking cessation resources and up to six brief counseling calls with a trained cessation counselor. The counselor used motivational interviewing techniques during the three-month intervention and leveraged patients' screening results as a motivator to stop smoking. The control group (n=46) only received the list of evidence-based cessation resources without any counseling services.

The results: More patients in telephone-based counseling group quit smoking

When comparing the number of patients in each group that quit smoking after three months, the researchers found that the patients receiving telephone counseling had a 300% higher quit rate than the standard care group (17.4% vs. 4.3%). Researchers used biochemical testing to confirm that patients who claimed they quit smoking actually did.

Well-timed smoking cessation counseling is critical, but doesn't have to be resource intensive

Cancer programs can learn two key things about effective smoking cessation programs from the success of this intervention:

  1. Timing is everything. Proactively providing smoking cessation counseling, rather than just an overview of smoking cessation resources, to patients soon after they receive a lung cancer screening may increase their likelihood of stopping smoking.

  2. Providing smoking cessation counseling doesn't have to be resource intensive. Leveraging telehealth to counsel high-risk patients is a cost-effective alternative to in-person counseling and has the potential to increase patient participation by allowing them to complete these sessions from the comfort of their own home.

Lung cancer screening best practices from 130 oncology program leaders

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