Uptake and 4-week outcomes of an ‘opt-out’ smoking cessation referral strategy in a London-based lung cancer screening setting

Uptake and 4-week outcomes of an ‘opt-out’ smoking cessation referral strategy in a London-based lung cancer screening setting

Introduction Lung cancer screening (LCS) enables the delivery of smoking cessation interventions to a population experiencing long-term tobacco dependence, but the optimal delivery method remains unclear. Here, we report uptake and short-term outcomes of an ‘opt-out’ smoking cessation referral strat...

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Main Authors: Anthony Edey, Neal Navani, Kitty Chan, Graham Robinson, Janine Zylstra, Paul Robinson, Laura Green, Anand Devaraj, Jane Rowlands, Allan Hackshaw, Carolyn Horst, Arjun Nair, Sam M Janes, Kate Davies, Jeannie Eng, Mamta Ruparel, Samantha L Quaife, Jennifer L Dickson, Magali Taylor, Angshu Bhowmik, Hasti Robbie, Joseph Jacob, Laura Farrelly, Sophie Tisi, Tanya Patrick, Andrew Creamer, Helen Hall, Samanjit Hare, Jon Teague, Samuel M Janes, Esther Arthur-Darkwa, Thea Buchan, Stephen Ellis, Thomas Callender, Rachael Sarpong, John McCabe, Zaheer Mangera, Ethaar El-Emir, Terry O'Shaughnessy, Geoff Bellingan, Nick Screaton, Priyam Verghese, William M Ricketts, Vicky Bowyer, Kylie Gyertson, Fanta Bojang, Claire Levermore, Tania Anastasiadis, Ruth Prendecki, Amyn Bhamani, Malavika Suresh, Judy Airebamen, Alice Cotton, Kaylene Phua, Elodie Murali, Simranjit Mehta, Karen Parry-Billings, Columbus Ife, April Neville, Zahra Hanif, Helen Kiconco, Ricardo McEwen, Dominique Arancon, Nicholas Beech, Derya Ovayolu, Christine Hosein, Sylvia Patricia Enes, Qin April Neville, Aashna Samson, Urja Patel, Fahmida Hoque, Hina Pervez, Sofia Nnorom, Moksud Miah, Julian McKee, Mark Clark, Anant Patel, Sara Lock, Rajesh Banka, Ugo Ekeowa, Charlotte Cash, Tunku Aziz, Alberto Villanueva, Elena Stefan, Charlie Sayer, Navinah Nundlall, Andrew Crossingham, Tanita Limani, Kate Gowers, Andrew Perugia, James Rusius, Anne-Marie Hacker, Monica L Mullin, Evangelos Katsampouris, Chuen R Khaw, Chuen Khaw, Sheetal Karavadra, Alan Shaw, Chris Valerio, Ali Mohammed, Lynsey Gallagher, Mehran Azimbagirad, Burcu Ozaltin, Maureen Browne, Eleanor Hellier, Catherine Nestor
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/12/1/e002337.full
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Summary:Introduction Lung cancer screening (LCS) enables the delivery of smoking cessation interventions to a population experiencing long-term tobacco dependence, but the optimal delivery method remains unclear. Here, we report uptake and short-term outcomes of an ‘opt-out’ smoking cessation referral strategy in an LCS cohort.Methods Individuals currently smoking tobacco who attended a face-to-face lung health check in the SUMMIT study (NCT03934866) were offered very brief advice on smoking cessation and where possible, an ‘opt-out’ referral to their local stop smoking service (SSS). Aggregate data on referral outcomes were obtained from each SSS individually.Results 33.7% (n=2090/6203) of individuals currently smoking tobacco consented to a practitioner-made ‘opt-out’ smoking cessation referral. 42.7% (n=893/2090) of these individuals resided in boroughs where SSS were not present or required self-referral. Males (adjusted OR (aOR) 1.16), younger individuals (55–59: aOR 1.70, 60–64: aOR 1.71 and 65–69: aOR 1.78) and those of ethnic minority backgrounds (Asian: aOR 1.31, Black: aOR 1.71 and Mixed: aOR 1.72) were more likely to consent, while individuals from the most deprived socioeconomic quintile were less likely to do so (aOR 0.65).High level of motivation to quit within a defined time frame (aOR 1.92), previous quit attempts in the past 12 months (1–4: aOR 1.65 and ≥5: aOR 1.54) and time to first cigarette of ≤60 min (<5: aOR 2.07, 6–30: aOR 1.55 and 31–60: aOR 1.56) were measures of tobacco dependence associated with a higher likelihood of providing consent.Outcomes were available for 742 referrals. An appointment with the service was accepted by 47.3% (n=351/742) of individuals, following which 65.5% (n=230/351) set a quit date. The 4-week quit rate among those setting a quit date and all individuals referred was 57.4% (n=132/230) and 17.8% (n=132/742), respectively.Conclusion A proactive, ‘opt-out’ smoking cessation referral strategy for individuals currently smoking tobacco who interact with an LCS programme may be beneficial.
ISSN:2052-4439

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