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.

• Undergraduate education: College of Medicine, Seoul National University, Seoul, Korea
• Graduate course: Department of Public Health and Management, The Graduate School, Seoul National University, Seoul, Korea
• PhD: Department of Medicine (Family Medicine), College of Medicine, Seoul National University, Seoul, Korea
• Professor, Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center