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Fucito: Smokers should be encouraged to quit at lung cancer screenings

March 09, 2016
by Christopher Gardner

Smokers who go to a doctor to be screened for lung cancer should also be encouraged to quit smoking during their visit, according to a paper by Lisa M. Fucito, PhD, assistant professor of psychiatry at Yale.

Fucito is the lead author of the position statement, published online February 24, 2016, in Cancer, a peer-reviewed journal of the American Cancer Society.

The article references a recent U.S. Preventive Services Task Force recommendation that heavy smokers undergo a yearly screening for lung cancer. The Centers for Medicare and Medicaid Services (CMS) has also approved lung cancer screenings as a preventive service benefit.

Screenings are an opportunity to encourage smokers to quit, however the Task Force does not provide specific details for how smoking-cessation treatment should be offered in conjunction with lung cancer screening, according to the authors.

“We applaud this Task Force recommendation. Lung cancer screening will save many lives by detecting lung cancer at earlier, treatable stages,” Fucito said. “But, providing lung cancer screening without smoking cessation services has risks. Most smokers will receive negative results. Smokers may perceive that smoking is not harmful if their screening results are negative. Others may view positive test results as evidence that smoking cessation would be of limited benefit at this point."

“Moreover, for patients who express an interest in quitting following screening, failure to provide evidence-based interventions may limit their success,” she said. “Pairing smoking cessation services close to the time of screening would reduce all of these risks.”

The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed this guideline for addressing smoking among smokers who seek lung cancer screening.

“Quitting smoking remains the single most important step patients can take to reduce their chances of developing lung cancer and to improve their prognosis following a lung cancer diagnosis,” Fucito said. “Pairing smoking cessation with lung cancer screening will maximize the benefits of screening.”

Fucito is director of the Tobacco Treatment Service at Smilow Cancer Hospital at Yale-New Haven. The program helps cancer patients quit smoking by combining counseling and drug treatment.

Among the paper’s other authors was Benjamin A. Toll, PhD, lecturer in psychiatry at Yale.

Submitted by Christopher Gardner on March 09, 2016