WCLC 2022 | YESS: personalized smoking cessation support in a lung cancer screening programme
Rachael Louise Murray, PhD, FRCR, MRCP, MB ChB, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom, provides an overview of the Yorkshire Enhanced Stop Smoking Study (YESS) (NCT03750110). Every eligible smoker who attended for lung cancer screening would be offered an immediate consultation with the stop smoking advisor on an opt-out basis. Behavioral support was offered with pharmacotherapy, which included nicotine replacement therapy or E-cigarette supplies. The same treatment was provided for 4 weeks to all participants. At 4 weeks, if participants had ceased smoking, carbon monoxide validation was used to validate they had quit and participants were offered enrollment into the YESS study. The YESS study is a double-blind randomized controlled trial of an enhanced, personalized smoking cessation support package including a booklet containing CT images of the participants’ own heart and lungs, annotated where appropriate to highlight emphysema or coronary artery calcification (CAC) with accompanying explanatory text, and scripted behavioral support delivered by a trained smoking cessation practitioner, compared to continued standard best practice. Participants were followed-up at 3- and 12-months, collecting smoking status, psychological change variables, quality of life and health care usage. This interview took place at the IASLC 2022 World Conference on Lung Cancer congress in Vienna, Austria.
Transcript (edited for clarity)
The study was designed to look at the effect of adding a co-located and personalized stop smoking intervention to a lung cancer screening program. It’s funded by Yorkshire Cancer Research, and it’s nested within the Yorkshire Lung Screening trial, which is a big study looking at outcomes in the UK.
We were set up so that every eligible smoker who attended for lung cancer screening would be offered an immediate consultation with the stop smoking advisor...
The study was designed to look at the effect of adding a co-located and personalized stop smoking intervention to a lung cancer screening program. It’s funded by Yorkshire Cancer Research, and it’s nested within the Yorkshire Lung Screening trial, which is a big study looking at outcomes in the UK.
We were set up so that every eligible smoker who attended for lung cancer screening would be offered an immediate consultation with the stop smoking advisor. We did this on an opt-out basis so that basically, unless people specifically refused to come and see us, they would come and have the initial consultation, then make a decision if they were going to proceed with stop smoking support.
We offered behavioral support, one-to-one counseling session, and that was accompanied by pharmacotherapy. So, nicotine replacement therapy and or e-cigarettes and vaping supplies. Or if people preferred, we’d refer them back to their general practitioner for varenicline or bupropion drugs.
We conducted this with everybody, and everyone that was willing got the same treatment for the first four weeks. At four weeks, we saw everybody back again, we measured their smoking status, and if they’d quit smoking, then we used something called carbon monoxide validation to validate and prove that they’d successfully quit. And at that point we offered enrollment into the YESS study. So, people consented, they either entered the usual care arm, which was the same support that they’d already had for another eight weeks, or 12 weeks in total, and our intervention group got exactly the same support as the usual care. But in addition, we used our personalized intervention and that contained images taken from their CT scan, images of their heart and images of their lungs, accompanied by scripted advice from the smoking cessation practitioner. And then we followed everybody up at 3 months and 12 months, collected smoking status, psychological change variables, and quality of life and healthcare usage. So that was our kind of methodology.
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