The Optimizing Lung Screening Trial (WF-20817CD): Multicenter Randomized Effectiveness Implementation Trial to...

Area of Science:

• Public Health
• Oncology
• Implementation Science

Background:

• Half of individuals undergoing lung cancer screening (LCS) currently use tobacco.
• Effective tobacco cessation strategies integrated into LCS encounters are under-researched.
• Optimizing tobacco cessation during LCS is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of the Optimizing Lung Screening intervention (OaSiS) in reducing tobacco use among LCS patients.
• To assess the implementation of tobacco cessation strategies within community-based radiology facilities.
• To determine if the OaSiS intervention improved tobacco abstinence rates compared to usual care.

Main Methods:

• A cluster randomized trial involving 26 radiology facilities across 20 states.
• The OaSiS intervention involved clinic and care team strategies compared to usual care.
• 1,094 adult tobacco users undergoing LCS completed baseline surveys; 956 completed 6-month follow-up with biochemical verification for abstinence.

Main Results:

• A significant increase in average self-reported tobacco abstinence rates was observed over time (0% to ~13%).
• However, no statistically significant difference in tobacco use abstinence was found between the OaSiS intervention group and the usual care group at 14 days, 3 months, or 6 months.
• Individual facility abstinence rates varied widely (0%-27%).

Conclusions:

• While participants showed a general trend toward reduced tobacco use over the study period, the OaSiS intervention did not demonstrate a significant effect on tobacco abstinence compared to usual care.
• Further research is needed to identify and refine effective strategies for tobacco cessation within lung cancer screening programs.
• Implementation of tobacco cessation interventions in real-world clinical settings like radiology facilities presents challenges that require tailored approaches.