Exploring the predictors and barriers to accepting smoking cessation support within a targeted lung health check...

The Quit Smoking Lung Health Intervention Trials (QuLIT-1 and -2), and other studies, show that providing immediate smoking cessation support within lung cancer screening services substantially improves quit rates. However, in the QuLIT2 trial, only around half of those offered smoking cessation support actually accepted it. Understanding what underpins this and how to facilitate higher engagement would enhance the health impact of the Targeted Lung Health Check programme.

We compared characteristics of participants in the intervention arm of the QuLIT-2 study who accepted or declined the offer of smoking cessation support and conducted thematic analysis of interviews with 15 smokers who had declined it.

Of 152 study participants randomised to smoking cessation support (61.3±4.8 years, 42% female), 80 declined the offer and 15 dropped out after the initial session, leaving 57 'accepters'. Accepters were more likely to be female (53% vs 40% adjusted OR (AOR): 3.30, 95% CI 1.47 to 7.48), younger (AOR: 0.90 (0.80 to 0.98)) and were more likely to live in areas of medium or low deprivation (AOR: 5.30 (1.86 to 22.85)). Thematic analysis of the interviews revealed four main barriers to acceptance: (1) mental health as a barrier, (2) personal beliefs about quitting smoking, (3) perceived usefulness of the interventions offered and (4) past negative experiences of smoking cessation support.

Cessation services embedded in lung screening programmes need to anticipate barriers such as mental health concerns, past unsuccessful quit attempts experiences and personal beliefs. Efforts should be made to design and offer equitable services that meet the needs of this population.

ISRCTN12455871.