Promoting Smoking Cessation in Lung Cancer Screening Through Proactive Treatment (PROACT)

VA Office of Research and Development

Status: Completed

Conditions: Lung Neoplasms; Lung Diseases; Tomography; Smoking Reduction; Tobacco Smoking; Tobacco Use

Treatments: Behavioral: Proactive Telephone Counseling from VA Quitline; Behavioral: Unsigned note to provider about cessation medication prescription

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT03612804

IIR 16-071

Details and patient eligibility

About

This pragmatic trial will evaluate the value of routinely providing proactive smoking cessation support to current smokers as a part of participating in lung cancer screening within Veterans Health Administration.

Full description

This trial is a pragmatic randomized trial targeting the care of current smokers who are participating in lung cancer screening at two VA sites. Primary care providers at these sites will be randomized, and half will be offered tools to help integrate proactive smoking cessation support into the lung cancer screening process. Key proactive elements include proactive telephone outreach to all current smokers by a VA Quitline counselor that follows mailed results letters, and providing providers guidance in offering proactive cessation medication support as part of the lung cancer screening process.

Enrollment: 944 patients

Sex: All

Ages: Under 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Providers who schedule patients for a lung cancer screening at either of the two VA sites.
• Patients who participate in lung cancer screening and are current smokers at the time of scheduling their screening exam.

Exclusion criteria

• Providers who currently systematically prescribe cessation support medication to all current smokers will be excluded.
• Patients with urgent findings requiring biopsy/immediate attention on the screening CT will be excluded.
• Patients with a prior diagnosis of lung cancer or who are receiving active therapy for any cancer, except skin cancer, will be excluded.
• Patients previously diagnosed with cognitive impairment, dementia, or severe behavioral disorders, or have an indication in chart review of difficulty communicating or participating in telephone counseling sessions will be excluded.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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944 participants in 2 patient groups

Unstructured care

No Intervention group

Description:

Providers in this arm will continue to provide care as usual during lung cancer screening, with no intervention from the study team.

Proactive care

Experimental group

Description:

Providers in this arm will receive guidance from the study team about offering lung cancer screening patients proactive cessation care, including cessation medications and behavioral telephone counseling.

Treatment:

Behavioral: Unsigned note to provider about cessation medication prescription

Behavioral: Proactive Telephone Counseling from VA Quitline