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Grant Details

Grant Number: 5R01CA207229-06 Interpret this number
Primary Investigator: Toll, Benjamin
Organization: Medical University Of South Carolina
Project Title: Gain-Framed Messages and Nrt Sampling to Promote Smoking Cessation in Lung Cancer Screening Programs
Fiscal Year: 2022


PROJECT SUMMARY/ABSTRACT Lung cancer is now the leading cause of cancer death in both men and women in the U.S. In addition to primary prevention (tobacco control), secondary prevention through early detection with low-dose CT scans is recognized as a technique to identify earlier stage, more treatable lung cancers in high-risk patients. Evidence from the National Lung Screening Trial (NLST) showed that lung cancer screening with low-dose CT scans for high risk individuals (>30 pack years of smoking, <15 yr quit-time, and 55-74 yrs of age) conferred a 20% reduction in mortality for those patients who received 3 annual low dose CT scans. The U.S. Preventive Services Task Force (USPSTF) recently issued a final recommendation for annual screening for lung cancer in these high risk individuals, and many insurers now cover the screening. The present study is thus timely and novel – we will investigate whether we can achieve higher rates of short- and long-term cessation in this high risk population. We will conduct a 2 x 2 (gain-framed intervention vs. unframed intervention, starter package of 2 weeks of nicotine patches and lozenges vs. no medication) study to evaluation methods to boost rates of smoking cessation for a high-risk group of smokers (N=616) with varying levels of motivation across 2 study sites (MUSC, Yale). Participants will be identified through the MUSC and Yale lung cancer screening programs at both sites. Randomization will be stratified by study site and level of motivation. The primary hypothesis is that rates of smoking cessation will be significantly higher at 6-months after lung screening for the smoking cessation strategy involving a gain-framed intervention + 2 weeks of nicotine patches and lozenges compared to a strategy of an unframed behavioral intervention + no medication. Our secondary hypothesis is that rates of smoking cessation will be higher for the gain-framed intervention group vs. the unframed intervention group and the starter package of 2 weeks of nicotine patches and lozenges group vs. the no medication group. On an exploratory basis we will also examine mediators and moderators of treatment. We hypothesize that changes in self-efficacy, smoking cessation outcome expectancy, familiarization with NRT, motivation, and autonomy will act as mechanisms for the smoking cessation effects (i.e., will act as mediators of treatment). We also hypothesize that lung screening findings (e.g., presence of a nodule, cancer, etc), nicotine dependence, and health disparities will modify treatment response (i.e., will act as baseline moderators of treatment). This project is designed to be translational (in that it can be transferable from our controlled efficacy study to other lung screening programs at other institutions) as all of our media will be digital files ready for sharing, the procedures for NRT sampling will be easily copied, and the print materials can be provided as fillable templates for personalization.


Factors Associated With Smoking Cessation Attempts in Lung Cancer Screening: A Secondary Analysis of the National Lung Screening Trial.
Authors: Thomas N.A. , Ward R. , Tanner N.T. , Rojewski A.M. , Toll B. , Gebregziabher M. , Silvestri G.A. .
Source: Chest, 2023 Feb; 163(2), p. 433-443.
EPub date: 2022-09-23.
PMID: 36162480
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Accelerating integration of tobacco use treatment in the context of lung cancer screening: Relevance and application of implementation science to achieving policy and practice.
Authors: Shelley D. , Wang V.H. , Taylor K. , Williams R. , Toll B. , Rojewski A. , Foley K.L. , Rigotti N. , Ostroff J.S. .
Source: Translational behavioral medicine, 2022-11-21; 12(11), p. 1076-1083.
PMID: 36227937
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Examining Tobacco Treatment Perceptions and Barriers among Black versus Non-Black Adults Attending Lung Cancer Screening.
Authors: Bold K.W. , Cannon S. , Ford B.B. , Neveu S. , Sather P. , Toll B.A. , Fucito L.M. .
Source: Cancer prevention research (Philadelphia, Pa.), 2022-05-03; 15(5), p. 327-333.
PMID: 35063942
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Predictors of Enrollment of Older Smokers in Six Smoking Cessation Trials in the Lung Cancer Screening Setting: The Smoking Cessation at Lung Examination (SCALE) Collaboration.
Authors: Eyestone E. , Williams R.M. , Luta G. , Kim E. , Toll B.A. , Rojewski A. , Neil J. , Cinciripini P.M. , Cordon M. , Foley K. , et al. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2021-11-05; 23(12), p. 2037-2046.
PMID: 34077535
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Use and perceptions of electronic nicotine delivery systems among patients attending lung cancer screening who smoke.
Authors: Fucito L.M. , Bold K.W. , Baldassarri S.R. , LaVigne J.P. , Ford B. , Sather P. , O'Malley S.S. , Toll B.A. .
Source: Preventive medicine reports, 2021 Sep; 23, p. 101444.
EPub date: 2021-06-09.
PMID: 34235048
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Impact of the COVID-19 pandemic on telehealth research in cancer prevention and care: A call to sustain telehealth advances.
Authors: Park E.R. , Chiles C. , Cinciripini P.M. , Foley K.L. , Fucito L.M. , Haas J.S. , Joseph A.M. , Ostroff J.S. , Rigotti N.A. , Shelley D.R. , et al. .
Source: Cancer, 2021-02-01; 127(3), p. 334-338.
EPub date: 2020-10-13.
PMID: 33048350
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Association of Cigarette Type and Nicotine Dependence in Patients Presenting for Lung Cancer Screening.
Authors: Tanner N.T. , Thomas N.A. , Ward R. , Rojewski A. , Gebregziabher M. , Toll B.A. , Silvestri G.A. .
Source: Chest, 2020 Nov; 158(5), p. 2184-2191.
EPub date: 2020-06-27.
PMID: 32603713
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E-cigarettes: Tobacco policy and regulation.
Authors: Bold K.W. , Krishnan-Sarin S. .
Source: Current addiction reports, 2019 Jun; 6(2), p. 75-85.
EPub date: 2019-04-27.
PMID: 31555499
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Personalized Intervention Program: Tobacco Treatment for Patients at Risk for Lung Cancer.
Authors: Bold K.W. , Toll B.A. , Cartmel B. , Ford B.B. , Rojewski A.M. , Gueorguieva R. , O'Malley S.S. , Fucito L.M. .
Source: Journal of smoking cessation, 2018 Dec; 13(4), p. 244-247.
EPub date: 2017-12-11.
PMID: 32431757
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Tobacco Dependence Predicts Higher Lung Cancer and Mortality Rates and Lower Rates of Smoking Cessation in the National Lung Screening Trial.
Authors: Rojewski A.M. , Tanner N.T. , Dai L. , Ravenel J.G. , Gebregziabher M. , Silvestri G.A. , Toll B.A. .
Source: Chest, 2018 Jul; 154(1), p. 110-118.
EPub date: 2018-05-21.
PMID: 29793736
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Lung Cancer Screening and Smoking Cessation Clinical Trials. SCALE (Smoking Cessation within the Context of Lung Cancer Screening) Collaboration.
Authors: Joseph A.M. , Rothman A.J. , Almirall D. , Begnaud A. , Chiles C. , Cinciripini P.M. , Fu S.S. , Graham A.L. , Lindgren B.R. , Melzer A.C. , et al. .
Source: American journal of respiratory and critical care medicine, 2018-01-15; 197(2), p. 172-182.
PMID: 28977754
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Strategies for smoking cessation among high risk populations to prevent lung cancer.
Authors: Rojewski A.M. , Zuromski K.L. , Toll B.A. .
Source: Expert review of respiratory medicine, 2017 Feb; 11(2), p. 85-87.
EPub date: 2016-12-13.
PMID: 27910714
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