“It's a decision I have to make”: Patient perspectives on smoking and cessation after lung cancer screening decisions

Sara E. Golden, Liana Schweiger, Anne C. Melzer, Sarah S. Ono, Santanu Datta, James M. Davis, Christopher G. Slatore

Research output: Contribution to journalArticlepeer-review

Abstract

Few studies exist showing that involvement in lung cancer screening (LCS) leads to a change in rates of cigarette smoking. We investigated LCS longitudinally to determine whether teachable moments for smoking cessation occur downstream from the initial provider-patient LCS shared decision-making discussion and self-reported effects on smoking behaviors. We performed up to two successive semi-structured interviews to assess the experiences of 39 individuals who formerly or currently smoked cigarettes who underwent LCS decision-making discussions performed during routine care from three established US medical center LCS programs. The majority of those who remembered hearing about the importance of smoking cessation after LCS-related encounters did not report communication about smoking influencing their motivation to quit or abstain from smoking, including patients who were found to have pulmonary nodules. Patients experienced little distress related to LCS discussions. Patients reported that there were other, more significant, reasons for quitting or abstinence. They recommended clinicians continue to ask about smoking at every clinical encounter, provide information comparing the benefits of LCS with those of quitting smoking, and have clinicians help them identify triggers or other motivators for improving smoking behaviors. Our findings suggest that there may be other teachable moment opportunities outside of LCS processes that could be utilized to motivate smoking reduction or cessation, or LCS processes could be improved to integrate cessation resources.

Original languageEnglish (US)
Article number102014
JournalPreventive Medicine Reports
Volume30
DOIs
StatePublished - Dec 2022

Bibliographical note

Funding Information:
We would like to acknowledge the assistance of support of all the research assistants, project managers, and site-PIs at each site, as well as all the patients who participated in this study. Lead Site Investigators: VA Portland Health Care System- Christopher Slatore, MD, MS; VA Minneapolis- Anne C Melzer, MD, MS; Duke University Medical Center- Santanu Datta, PhD, James Davis, MD. Research and Clinical Teams: VA Portland Health Care System- Sara Golden, Sarah Ono, Leah Miranda, Tara Thomas, Philip Tostado, Molly Davis, Cynthia Sadak; VA Minneapolis- Angela Fabbrini, Megan Campbell, Ruth Balk, Miranda Deconcini; Duke University Medical Center- Jillian Dirkes, Leah Thomas, Betty Tong, MD. This study is supported by an award from the American Cancer Society 128737-RSG-155-01-CPPB, Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. It was also supported by resources from the VA Portland Health Care System, Portland, OR; the Minneapolis VA Healthcare System; Minneapolis, MN; and Duke University School of Medicine, Durham, NC.

Funding Information:
This study is supported by an award from the American Cancer Society 128737-RSG-155-01-CPPB, Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. It was also supported by resources from the VA Portland Health Care System, Portland, OR; the Minneapolis VA Healthcare System; Minneapolis, MN; and Duke University School of Medicine, Durham, NC.

Publisher Copyright:
© 2022

PubMed: MeSH publication types

  • Journal Article

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