Abstract Background Lung cancer mortality is reduced via low-dose computed tomography screening and treatment of early-stage disease. Evidence-based smoking cessation treatment in the lung screening setting can further reduce mortality. We report the results of a cessation trial from the National Cancer Institute’s Smoking Cessation at Lung Examination collaboration. Methods Eligible patients (n = 818) aged 50-80 years were randomly assigned (May 2017-January 2021) to the intensive vs minimal arms (8 vs 3 phone sessions plus 8 vs 2 weeks of nicotine patches, respectively). Bio-verified (primary) and self-reported 7-day abstinence rates were assessed at 3, 6, and 12 months post random assignment. Logistic regression analyses evaluated the effects of study arm. All statistical tests were 2-sided. Results Participants reported 48.0 (SD = 17.2) pack-years, and 51.6% were not ready to quit in less than 30 days. Self-reported 3-month quit rates were statistically significantly higher in the intensive vs minimal arm (14.3% vs 7.9%; odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.26 to 3.18). Bio-verified abstinence was lower but with similar relative differences between arms (9.1% vs 3.9%; OR = 2.70, 95% CI = 1.44 to 5.08). Compared with the minimal arm, the intensive arm was more effective among those with greater nicotine dependence (OR = 3.47, 95% CI = 1.55 to 7.76), normal screening results (OR = 2.58, 95% CI = 1.32 to 5.03), high engagement in counseling (OR = 3.03, 95% CI = 1.50 to 6.14), and patch use (OR = 2.81, 95% CI = 1.39 to 5.68). Abstinence rates did not differ statistically significantly between arms at 6 months (OR = 1.2, 95% CI = 0.68 to 2.11) or 12 months (OR = 1.4, 95% CI = 0.82 to 2.42). Conclusions Delivering intensive telephone counseling and nicotine replacement with lung screening is an effective strategy to increase short-term smoking cessation. Methods to maintain short-term effects are needed. Even with modest quit rates, integrating cessation treatment into lung screening programs may have a large impact on tobacco-related mortality.

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肺癌筛查中基于电话的戒烟治疗的随机试验

摘要 背景通过低剂量计算机断层扫描筛查和早期疾病治疗可以降低肺癌死亡率。在肺部筛查环境中进行循证戒烟治疗可以进一步降低死亡率。我们报告了美国国家癌症研究所肺部检查戒烟合作项目的戒烟试验结果。 方法年龄在 50-80 岁的符合条件的患者 (n = 818) 被随机分配（2017 年 5 月至 2021 年 1 月）至强化治疗组和最小治疗组（分别为 8 次电话会议和 3 次电话会议加 8 周和 2 周的尼古丁贴片）。在随机分配后 3、6 和 12 个月评估生物验证（主要）和自我报告的 7 天戒断率。逻辑回归分析评估了研究组的效果。所有统计检验都是双面的。 结果参与者报告了 48.0 (SD = 17.2) 包年，51.6% 的人在不到 30 天内没有准备好戒烟。强化组与最小组相比，自我报告的 3 个月戒烟率在统计学上显着更高（14.3% vs 7.9%；比值比 [OR] = 2.00，95% 置信区间 [CI] = 1.26 至 3.18）。生物验证的戒断率较低，但两组间的相对差异相似（9.1% vs 3.9%；OR = 2.70，95% CI = 1.44 至 5.08）。与最小组相比，强化组对于尼古丁依赖程度较高（OR = 3.47，95% CI = 1.55 至 7.76）、筛查结果正常（OR = 2.58，95% CI = 1.32 至 5.03）、高参与咨询（OR = 3.03，95% CI = 1.50 至 6.14）和贴剂使用（OR = 2.81，95% CI = 1.39 至 5.68）。 6 个月（OR = 1.2，95% CI = 0.68 至 2.11）或 12 个月（OR = 1.4，95% CI = 0.82 至 2.42）时，各组之间的戒断率没有统计学差异。 结论提供密集的电话咨询和尼古丁替代与肺部筛查是促进短期戒烟的有效策略。需要维持短期效果的方法。即使戒烟率适中，将戒烟治疗纳入肺部筛查计划也可能对烟草相关死亡率产生重大影响。