Effectiveness of smoking cessation interventions for smokers undergoing lung cancer screening: A systematic review and meta-analysis

Background: Smoking is the leading cause of lung cancer, and smoking cessation is crucial for reducing both the lung cancer incidence and mortality. We aimed to assess the effectiveness of smoking cessation interventions in smokers undergoing lung cancer screening (LDCT).

Methods: Two independent researchers conducted a systematic search and selection process for primary studies in September 2023, 10 RCTs (reported across 12 publications) were selected.

Results: Pooled analysis of 9 studies showed no statistically significant difference in smoking cessation rates of 3 months or longer between the intervention group and the control group receiving minimal or usual care (RR, 1.56; 95% CI, 0.90–2.69). In a cluster RCT by Foley et al. (2023), the odds ratio (OR) also indicated no significant difference between groups (OR, 0.97; 95% CI, 0.65–1.45). In subgroup analyses, smoking cessation interventions that included pharmacotherapy demonstrated significantly higher cessation success compared to controls (RR, 2.41; 95% CI, 1.32–4.39). Similarly, interventions classified as intensive smoking cessation treatments also showed significantly greater quit rates than less intensive or usual care interventions (RR, 2.00; 95% CI, 1.20–3.34). Serious adverse events did not differ significantly between groups in the single study that reported them (RR, 0.93; 95% CI, 0.63–1.36).

Conclusion: Active smoking cessation counseling and pharmacotherapy for smokers undergoing lung cancer screening is strongly recommended to current smokers undergoing LDCT screening test.

Funding: National Evidence-based Healthcare Collaborating Agency (NECA-A-23-013, NECA-A-24-002).

Cheol Min Lee completed his undergraduate education at the College of Medicine, Seoul National University in Seoul, Korea. He went on to pursue graduate studies in the Department of Public Health and Management at The Graduate School of Seoul National University. Further advancing his academic career, he earned a PhD from the Department of Medicine (Family Medicine) at the same university. Currently, he serves as a professor in the Department of Family Medicine at the Seoul National University Hospital Healthcare System Gangnam Center.