--- title: "Stop smoking steps after lung cancer screen guideline change | Sutter Health" description: "After implementation of new lung cancer screening guidelines, smoking-cessation interventions increased. This could have substantial public health benefits." url: "https://www.sutterhealth.org/research/publications/stop-smoking-steps-after-lung-cancer-screen-guideline-change-1055312754" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Stop smoking steps after lung cancer screen guideline change # Smoking-cessation interventions after lung cancer screening guideline change. Li J, Chung S, Martinez MC, & Luft HS. _Am J Prev Med. pii: S0749-3797(20)30101-X. doi: 10.1016/j.amepre.2020.01.031. \[Epub ahead of print\]_ 2020-05-14 ## Abstract Introduction: Recent guideline changes for lung cancer screening with low-dose computed tomography recommend smoking-cessation interventions be done in parallel with screening. The purpose of this study is to determine the post-guideline rates of smoking-cessation interventions among patients eligible and ineligible for lung cancer screening. Methods: Using electronic health records collected from a large ambulatory care system in northern California between 2010 and 2017, authors identified new patients who were current smokers aged 55-80 years visiting a primary care provider, and grouped patients into lung cancer screening-eligible heavy smokers, screening-ineligible moderate smokers, and screening-ineligible light smokers. Screening-eligible smokers versus screening-ineligible smokers were compared in receipt of smoking-cessation interventions before (2010-2013) and after (2014-2017) the guideline change, overall and by intervention type (formal counseling, informal counseling, pharmacotherapy) using hierarchical generalized linear models. Analyses were conducted in 2018-2019. Results: After the guideline change, the likelihood of receiving any smoking-cessation intervention (OR=1.44, 95% CI=1.28, 1.61, p<0.05), informal counseling (OR=1.29, 95% CI=1.15, 1.46, p<0.05), and pharmacotherapy (OR=1.24, 95% CI=1.02, 1.50, p<0.05) during a new patient visit significantly increased, with the increase not varying by level of smoking. For formal counseling, the post-guideline increase was greater for screening-eligible heavy smokers (OR=3.15, 95% CI=1.18, 8.36, p<0.05) and moderate smokers (OR=3.58, 95% CI=1.29, 9.95, p<0.05) relative to light smokers. Conclusions: Smoking-cessation interventions increased after new lung cancer screening guidelines. Given the sizable adverse impacts of smoking on morbidity and mortality, small increases in the implementation of smoking-cessation interventions could have substantial public health benefits. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/32417022/) ![Jiang Li, Ph.D., MPH](https://dyn.mktgcdn.com/p/H4OFJqNxBzDqkSWaIqDBiZgqIsHNsHLWdLuMd9IlNx0/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Jiang Li, Ph.D., MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008) ## Research topics - [Lung Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Lung+Cancer%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Smoking](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Smoking%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [New recommendation and coverage of low-dose computed tomography for lung cancer screening: uptake has increased but is still low.](https://www.sutterhealth.org/research/publications/ldct-lung-ca-screening-low-uptake-1055312362) Li J, Chung S, Wei EK, Luft HS. BMC Health Serv Res. 18(1):525. doi: 10.1186/s12913-018-3338-9. 2018 Jul 05 - Publication ### [Meaningful use in practice using patient-specific risk in an electronic health record for shared decision making.](https://www.sutterhealth.org/research/publications/shared-decision-making-using-pt-specific-risk-in-ehr-1055312661) Jones JB, Shah NR, Bruce CA, Stewart WF. Am J Prev Med. 40(5 Suppl 2):S179-86. doi: 10.1016/j.amepre.2011.01.017. 2011 May 01 - Publication ### [Personalized hypertension management using patient-generated health data integrated with electronic health records (EMPOWER-H): six-month pre-post study.](https://www.sutterhealth.org/research/publications/htn-mgmt-pt-generated-data-and-ehrs-1055312515) Lv N, Xiao L, Simmons ML, Rosas LG, Chan A, Entwistle M. J Med Internet Res. 19(9):e311. doi: 10.2196/jmir.7831. 2017 Sep 19 - Publication ### [Using the PARAFAC2 tensor factorization on EHR audit data to understand PCP desktop work.](https://www.sutterhealth.org/research/publications/parafac2-tensor-factorization-on-ehr-audit-data-pcp-work-1055312822) Perros I, Yan X, Jones JB, Sun J, Stewart WF. J Biomed Inform. 101:103312. doi: 10.1016/j.jbi.2019.103312. Epub 2019 Oct 15. 2020 Jan 01 - Publication ### [Machine learning and atherosclerotic cardiovascular disease risk prediction in a multi-ethnic population.](https://www.sutterhealth.org/research/publications/asvd-risk-prediction-in-multi-ethnic-population-1055312841) Ward A, Sarraju A, Chung S, Li J, Harrington R, Heidenreich P, Palaniappan L, Scheinker D, Rodriguez F. NPJ Digit Med. 3:125. doi: 10.1038/s41746-020-00331-1. eCollection 2020. 2020 Sep 23 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/stop-smoking-steps-after-lung-cancer-screen-guideline-change-1055312754#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Stop smoking steps after lung cancer screen guideline change"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/stop-smoking-steps-after-lung-cancer-screen-guideline-change-1055312754#medicalscholarlyarticle","name":"Smoking-cessation interventions after lung cancer screening guideline change.","headline":"Stop smoking steps after lung cancer screen guideline change","abstract":"Introduction: Recent guideline changes for lung cancer screening with low-dose computed tomography recommend smoking-cessation interventions be done in parallel with screening. The purpose of this study is to determine the post-guideline rates of smoking-cessation interventions among patients eligible and ineligible for lung cancer screening. Methods: Using electronic health records collected from a large ambulatory care system in northern California between 2010 and 2017, authors identified new patients who were current smokers aged 55-80 years visiting a primary care provider, and grouped patients into lung cancer screening-eligible heavy smokers, screening-ineligible moderate smokers, and screening-ineligible light smokers. Screening-eligible smokers versus screening-ineligible smokers were compared in receipt of smoking-cessation interventions before (2010-2013) and after (2014-2017) the guideline change, overall and by intervention type (formal counseling, informal counseling, pharmacotherapy) using hierarchical generalized linear models. Analyses were conducted in 2018-2019. Results: After the guideline change, the likelihood of receiving any smoking-cessation intervention (OR=1.44, 95% CI=1.28, 1.61, p\u003c0.05), informal counseling (OR=1.29, 95% CI=1.15, 1.46, p\u003c0.05), and pharmacotherapy (OR=1.24, 95% CI=1.02, 1.50, p\u003c0.05) during a new patient visit significantly increased, with the increase not varying by level of smoking. For formal counseling, the post-guideline increase was greater for screening-eligible heavy smokers (OR=3.15, 95% CI=1.18, 8.36, p\u003c0.05) and moderate smokers (OR=3.58, 95% CI=1.29, 9.95, p\u003c0.05) relative to light smokers. Conclusions: Smoking-cessation interventions increased after new lung cancer screening guidelines. Given the sizable adverse impacts of smoking on morbidity and mortality, small increases in the implementation of smoking-cessation interventions could have substantial public health benefits.","description":"After implementation of new lung cancer screening guidelines, smoking-cessation interventions increased. 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