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This study assessed over 3,300 participants of the National Lung Screening Trial—all who were smokers at the time they enrolled in the trial—one year after they had received their lung cancer screening. Around half of the participants had quit smoking since their screening and the other half were used as matched controls.
The researchers examined whether clinicians’ use of the “5As”—ask, advise, assess, assist, and arrange—during the screening process for the trial had any bearing on quit rates, and found that only the last two elements made a significant difference. Providers who assisted patients by recommending strategies like counseling or medication increased the likelihood their patients quit smoking by 40%, while those who arranged follow-up calls or visits increased the chances that patients quit by 46%.
However, the number of clinicians who were active in assisting and/or arranging was fairly low. While over 75% of physicians asked about smoking status or advised their patient to quit, only 63% assessed patient interest in quitting, 56% assisted their patients, and 10% helped make arrangements.
The authors acknowledged that many primary care clinicians are busy and may not have the time to assist every patient they see, but given the improved odds, efforts could be made to develop collaborative or integrated care programs.
To learn more about how integrated care may be valuable in smoking cessation, especially for people with mental health issues, see the Psychiatric News article “Smoking Cessation for Patients Called an Urgent Priority.” For additional information, see the Psychiatric Services study “Increasing Tobacco Dependence Treatment Through Continuing Education Training for Behavioral Health Professionals.”
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