Preventing Lung Cancer through Tobacco Cessation at FDNY

纽约消防局通过戒烟预防肺癌

• 批准号: 10748119
• 负责人: Shadi Nahvi
• 金额: $ 25.87万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748119
• 关键词: Preventing; Lung; Cancer; through; Tobacco

Project Summary/Abstract Quitting smoking at any age can have significant health benefits which extend beyond its well-recognized impact on cancer. The Fire Department of the City of New York (FDNY) World Trade Center Health Program (WTCHP) is situated within its occupational health clinics. All participants in the FDNY WTCHP low dose computed tomography (LDCT) lung cancer screening program have access to a free, tobacco cessation program (typically cessation counseling plus nicotine replacement treatment). While many are now former smokers, 36% of LDCT program participants continue to smoke. Novel strategies are needed to engage WTCHP members who continue to smoke into evidence-based smoking cessation treatment. In the proposed trial, participants in the FDNY WTCHP LDCT screening program who are retired from FDNY will be randomized to receive Standard Care: a letter with information about LDCT screening and the free FDNY Tobacco Cessation program including varenicline treatment and cessation counselling via telemedicine or Enhanced Care: a letter informing them that they will be enrolled in the FDNY Tobacco Cessation Program unless they opt-out, similar access to varenicline treatment, but coupled with individually-tailored telemedicine sessions with our tobacco treatment specialist using that person’s most recent LDCT results to personalize cessation messaging. All participants will receive varenicline “preloading,” i.e., four weeks of treatment prior to their target quit date followed by 12 weeks of treatment, an approach shown to decrease pre-quit tobacco- associated reward. Each of the essential elements of this Enhanced Care method: opt-out enrollment and individually-tailored biofeedback linked to LDCT results has been shown to be effective in other settings.1-5 This protocol is the first to combine these elements plus varenicline treatment with preloading in a randomized trial of high-risk smokers (defined as those meeting LDCT screening criteria plus WTC exposure) who have either not enrolled in tobacco cessation or not succeeded in previous quit attempts under Standard Care. We hypothesize that the FDNY Enhanced Care Program will be associated with both increased enrollment and improved rates of tobacco treatment outcomes compared with Standard Care. Specific Aim 1: To compare enrollment (participation in a first visit with our tobacco treatment specialist) in the FDNY Tobacco Cessation Program by Standard Care vs. Enhanced Care methods. Specific aim 1a: To evaluate demographic and clinical characteristics associated with FDNY Tobacco Cessation Program enrollment. Specific Aim 2: To compare outcomes (retention to study end-date, varenicline and counseling adherence and tobacco quit rates) in the FDNY Tobacco Cessation Program by Standard Care vs. Enhanced Care methods. Specific Aim 2a: To evaluate demographic and clinical characteristics associated with tobacco treatment outcomes.

项目总结/摘要 在任何年龄戒烟都可以带来显着的健康益处，这些益处超出了公认的 对癌症的影响。纽约市消防局（FDNY）世界贸易中心健康计划 （WTCHP）位于其职业健康诊所内。FDNY WTCHP低剂量组的所有受试者 计算机断层扫描（LDCT）肺癌筛查计划获得免费的，戒烟 计划（通常是戒烟咨询加尼古丁替代治疗）。虽然许多人现在是前 吸烟者中，36%的LDCT计划参与者继续吸烟。需要新的战略来参与 WTCHP成员谁继续吸烟纳入循证戒烟治疗。拟议 试验中，从纽约消防局退休的纽约消防局WTCHP LDCT筛查项目参与者将 随机接受标准治疗：一封关于LDCT筛查和免费FDNY信息的信件 戒烟计划，包括伐尼克兰治疗和通过远程医疗提供戒烟咨询， 加强护理：一封信，通知他们将参加纽约消防局戒烟计划 除非他们选择退出，否则可以获得类似的伐尼克兰治疗，但同时提供个性化的远程医疗 与我们的烟草治疗专家进行的会议，使用该人最近的LDCT结果来个性化 戒烟信息。所有参与者将接受伐尼克兰“预负荷”，即，治疗前四周 他们的目标戒烟日期，然后是12周的治疗，这种方法被证明可以减少戒烟前的烟草， 相关奖励这种增强型护理方法的每个基本要素：选择退出登记和 与LDCT结果相关的个体定制生物反馈已被证明在其他环境中有效。 该方案是第一个在随机试验中联合收割机将这些元素与伐尼克兰治疗结合预负荷的方案 高风险吸烟者（定义为符合LDCT筛查标准加上WTC暴露的人）， 未参加戒烟或在标准治疗下既往戒烟尝试未成功。我们 我假设纽约消防局加强护理计划将与增加的入组人数和 与标准治疗相比，烟草治疗结果的改善率。 具体目标1：比较两组的入组情况（参加我们的烟草治疗专家的首次访视）， FDNY标准护理与增强护理方法的戒烟计划。 具体目标1a：评价FDNY烟草相关的人口统计学和临床特征 停止计划注册。 具体目标2：比较结果（保留至研究结束日期、伐尼克兰和咨询依从性以及 通过标准护理与增强护理方法，在FDNY戒烟计划中观察到的戒烟率。 具体目标2a：评价与烟草相关的人口统计学和临床特征 治疗结果。