P1.01-019 Integration of Tobacco Cessation Counseling in a Lung Screening Program

Abstract

In the lung screening population, the prevalence of lung cancer is typically a small percentage (2.3% (10/440) in our institution’s program). A much more common, treatable, and potentially overlooked condition in the lung screened patient population is nicotine addiction. The National Lung Screening Trial contained 49% current smokers. A review of our lung cancer screening program showed 70.2% (309/440) of patients were active smokers at the time of lung screening. Our lung screening program is designed so that all scheduling would be done by a coordinator who is a Nurse Practitioner and a Certified Tobacco Treatment Specialist. A telephone call to schedule the scan was done by the coordinator and basic tobacco cessation intervention was integrated into every call. Further follow up as face-to-face counseling was offered. We reviewed institutional data to determine what proportion of active smokers would agree to individualized counseling when it would be conveniently offered at the point of the scan, by the person coordinating the program. Over a consecutive 26 month period, 440 patients underwent lung screening. The majority of patients (70.2%, 309/440) were actively smoking. Telephone intervention reached 100% (309/309). The telephone intervention consisted of an Ask, Advise, Refer strategy which offered further resources including: a quitline referral, a weekly group counseling session referral, and an in depth personal counseling session which would be provided at the time and place of the screening scan. The same tobacco treatment specialist who provided telephone intervention, met face-to-face with 80.6% (249/309) of active smokers for in depth counseling and development of a cessation plan. Our lung screening program detected lung cancer in a minority of participants (2.3%, 10/440) but encountered nicotine addiction in the majority of participants (70.2%, 309/440). Positioning Certified Tobacco Treatment Specialists as coordinators of lung screening programs ensure that all participants receive at minimum a telephone intervention. The initial telephone intervention coinciding with scheduling the screening scan allowed a relationship to develop between the patient and the coordinator (who is tobacco cessation specialist). Most participants who were smoking (80.6%, 249/309) agreed to in depth counseling which was conveniently provided at the point of service with the screening scan. Without integration of the resources, few patients would have sought out cessation counseling. As lung screening will recur annually, this will provide longitudinal support. Further data about acceptance of counseling and data about long term cessation in a lung screening program will be gathered.