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Cancer Screening Boosts Smokers' Chances of Quitting

But many still can't kick the habit

MONDAY, Oct. 20, 2003 (HealthDayNews) -- Smokers who are screened for lung cancer appear more likely to quit in the year following the screening.

Specifically, a new study found smokers who had a spiral CT scan screening quit at a rate of 14 percent, about double the 5 percent to 7 percent rate in the general population.

If these people got more prodding in the form of smoking cessation messages and programs, an even greater percentage might kick the habit, the researchers speculate.

"It suggests an opportunity for being more systematic in providing smoking cessation services to people who are coming for screening," says Edwin Fisher, a spokesman for the American Lung Association and a professor of psychology, medicine and pediatrics at Washington University in St. Louis.

"If 14 percent of people quit just by completing screening, could we get that up to 30 percent if we offered some telephone counseling or smoking cessation groups or things of this nature?" adds Fisher, who was not involved in the study.

The results of the research, which was conducted at the Mayo Clinic in Rochester, Minn., appear in the Dec. 1 issue of Cancer.

Spiral CT scans are a relatively new method of detecting lung cancer and are still controversial among experts. While the American Cancer Society and other organizations do not endorse the method, it is being marketed directly to smokers as a way to detect disease earlier than conventional X-rays.

Researchers at the Mayo Clinic recruited people with long smoking histories (the median was 45 "pack years" of smoking, with one pack per day for 20 years equaling 20 pack years). Of the total, 901 were current smokers and 574 were former smokers.

All received a low-dose, fast spiral chest CT scan screening for lung cancer, and the majority received basic advice on how to stop smoking but nothing beyond "usual care," says study author Dr. Lisa Sanderson Cox, who is now at Georgetown University.

Overall, more people having the screening quit during the following year than would be expected to quit in the general population. Older smokers and those who had poorer lung function were most likely to quit. The results of the scan, on the other hand, did not seem to influence people's decision.

The study also found the longer you had been abstinent, the more likely you were to stay that way. Individuals who came to the screening with a year or less of not smoking had a 30 percent relapse rate. Those who had abstained for two or more years had a lapse rate of only 2 percent.

This suggests that recent quitters might also benefit from an intervention, such as suggestions from a health expert on how to stop smoking. "If you're thinking in terms of cost efficiency, perhaps a modest intervention for those who have quit already but haven't been off that long would help them stay off," Fisher says.

Although the study authors did not explicitly address why they got these results, a number of explanations are possible.

People who go for CT scans may be more motivated and worried about their health than most, Fisher guesses.

Interaction with professionals at the time of the screening may also have helped.

"We know that brief interventions from health professionals will get a few percentage points of smokers to quit," Fisher says. "The simple act of getting screened and perhaps a casual conversation with technicians and others during screening about how it's great you're coming in and wouldn't it be wonderful if you could quit smoking, those kinds of interactions may have prompted some to quit."

Even so, most of the study participants did not quit during the following year.

"The fact that the majority continued to smoke despite health concerns shows that nicotine dependence is very strong and stopping smoking can be very difficult without help," Cox says.

"What would be helpful would be personal advice to stop smoking, including medication recommendations, referrals to local stop-smoking supports in the area, written materials, prescriptions, Web site recommendations for additional information and support and, ideally, follow-up at the next visit," she adds.

More information

The American Lung Association has more on quitting smoking and on lung cancer.

SOURCES: Edwin Fisher, Ph.D., professor, psychology, medicine and pediatrics, Washington University, St. Louis; Lisa Sanderson Cox, M.D., assistant professor, oncology, Lombardi Cancer Center, Georgetown University, Washington, D.C.; Dec. 1, 2003, Cancer
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