Predictors of attrition in a smoking cessation trial conducted in the lung cancer screening setting.
Predictors of attrition in a smoking cessation trial conducted in the lung cancer screening setting.
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DOI：
10.1016/j.cct.2021.106429
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发表时间：
2021-07
影响因子：
2.2
通讯作者：
Lung Screening, Tobacco and Health Trial
中科院分区：
文献类型：
--
作者：
Kim E;Williams RM;Eyestone E;Cordon M;Smith L;Davis K;Luta G;Anderson ED;McKee B;Batlle J;Ramsaier M;Howell J;Parikh V;Geronimo M;Stanton C;Niaura R;Abrams D;Taylor KL;Lung Screening, Tobacco and Health Trial
虽然要求对接受低剂量计算机断层扫描肺癌筛查（LCS）的吸烟者提供烟草治疗，但并非所有吸烟者都参与治疗。为了了解在这种情况下烟草治疗的障碍，我们评估了在接受LCS的个体中进行戒烟试验的损耗预测因素。在LCS之前，926名50-80岁的参与者完成了基线（T0）电话评估，包括人口统计学，临床，烟草和心理特征。在LCS和收到结果后，参与者完成了随机化前（T1）评估。在T1评估中，735名（79%）参与者被保留，191名（21%）退出。在多变量分析中，在吸烟>1包/天（OR=1.44，CI 1.01，2.06）或接受首次（与每年）LCS扫描（OR=1.70，CI 1.20，2.42）的患者中，损耗较高。在以下人群中，Attera较低：更多的教育（副学士（OR=.67，CI=.46，.98）或学士学位（OR= 0.56，CI 0.35，0.91）与高中/GED），一些（vs.没有/有一点）担心肺癌（OR=.60，CI .39，.92），或筛选结果为良性（OR=.57，CI .39，.82）或可能为良性（OR=.38，CI .16，.90）对比阴性。这项研究阐明了几个LCS相关的因素，有助于试验损耗。在这种情况下，增加烟草治疗将需要针对那些报告很少担心肺癌的人，正在进行首次LCS检查和/或LCS结果为阴性的人采取有针对性的策略。解决自然减员和减少烟草治疗的障碍将增加戒烟的可能性，从而降低患肺癌的风险。
Although it is a requirement that tobacco treatment is offered to cigarette smokers undergoing low-dose computed tomographic lung cancer screening (LCS), not all smokers engage in treatment. To understand the barriers to tobacco treatment in this setting, we evaluated predictors of attrition in a smoking cessation trial among individuals undergoing LCS. Prior to LCS, 926 participants, 50–80 years old, completed the baseline (T0) phone assessment, including demographic, clinical, tobacco, and psychological characteristics. Following LCS and receipt of the results, participants completed the pre-randomization (T1) assessment. At the T1 assessment, 735 (79%) participants were retained and 191 (21%) dropped out. In multivariable analyses, attrition was higher among those who: smoked >1 pack per day (OR=1.44, CI 1.01, 2.06) or had undergone their first (vs. annual) LCS scan (OR=1.70, CI 1.20, 2.42). Attrition was lower among those with: more education (associates (OR=.67, CI=.46, .98) or bachelorʼs degree (OR=.56, CI .35, .91) vs. high school/GED), some (vs. none/a little) worry about lung cancer (OR=.60, CI .39, .92), or a screening result that was benign (OR=.57, CI .39, .82) or probably benign (OR=.38, CI .16, .90) vs. negative. This study illuminated several LCS-related factors that contributed to trial attrition. Increasing tobacco treatment in this setting will require targeted strategies for those who report little lung cancer worry, are undergoing their first LCS exam, and/or who have a negative LCS result. Addressing attrition and reducing barriers to tobacco treatment will increase the likelihood of cessation, thereby reducing the risk of developing lung cancer.
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