Predictors of cessation readiness among cigarette smokers presenting for low-dose computed tomography lung cancer screening in community settings (WF-20817CD).

Abstract

Background: To plan cessation services and advance health equity, understanding factors related to cessation readiness and differences among patients presenting for lung cancer screening (LCS) is imperative.

Methods: We recruited smoking patients aged 55-77 years presenting for LCS in 26 community-based imaging clinics participating in an NCI Community Oncology Research Program (NCORP) site-randomized trial (WF-20817CD, UG1CA189824). We collected outcomes of smoking cessation readiness to change and quitting self-efficacy immediately prior to screening. Linear mixed models were constructed with site random effects to assess associations of outcomes and baseline characteristics.

Results: Participants (N=1,094; age=63.7; 81.9% White, 13.3% Black, 2.6% Hispanic, 2.3% American Indian; 20.2% non-metro) were even by gender (50.8% women) and educational attainment (51.1% ≤ high school education). Participants smoked an average of 17.2 cigarettes per day (SD=9.6), with mean pack year of 46.1 (SD=25.0). Predictors of increased cessation readiness included: being a man, increased worry about lung cancer, increased perceived benefits of quitting, quit attempt within past year, and smoking ≤ 10 cigarettes per day. For increased quitting self-efficacy: non-white race/ethnicity, men, less education, no use of other tobacco products, increased perceived benefits of quitting, quit attempt within past year, and smoking ≤ 10 cigarettes per day.

Conclusions: To support cessation among patients undergoing LCS, imaging clinics and health systems should recognize pre-screening readiness to quit varies by population subgroups. Imaging clinics may benefit from a tailored approach that works with patients "where they are."

Impact: These findings suggest that gender, race and ethnicity are associated with smoking cessation readiness and quitting self-efficacy.