||5R01CA207442-03 Interpret this number
||Sloan-Kettering Inst Can Research
||Optimizing Tobacco Treatment for Smokers Seeking Lung Cancer Screening
There is a timely and urgent need to understand and leverage the context of lung cancer screening to deliver
smoking cessation treatment and promote cessation among individuals at high risk for lung and other smoking-
related diseases. The long-term goal is to maximize the public health benefits of lung cancer screening by
providing a blueprint of best practices for integrating and sustaining tobacco treatment delivery in lung cancer
screening settings. The current project will make a vital contribution by identifying superior and scalable
tobacco treatment components with relevance for current smokers seeking screening that can be cost-
effectively delivered with high implementation fidelity by heterogeneous lung cancer screening sites. The
proposed research will use an innovative methodological framework, the Multiphase Optimization Strategy
(MOST), to design an optimized, scalable evidence-based tobacco treatment package that can be readily
integrated within lung cancer screening sites. MOST involves highly efficient, randomized experimentation to
precisely quantify the effects of individual treatment components and identify synergistic effects by combining
them into an effective tobacco treatment package. This information then guides assembly of an optimized
treatment package that achieves target outcomes with minimal resource consumption and staff burden. The
rationale for the proposed research is that once an optimized tobacco treatment package is established, future
comparative effectiveness trials can examine strategies for wider implementation and dissemination in LDCT-
LCS settings. In partnership with the Lung Cancer Alliance and their National Framework for Excellence in
Lung Cancer Screening, we will identify 18 heterogeneous lung cancer screening sites across the United
States that will serve as demonstration field sites. Sixty current smokers will be recruited from each of the 18
participating screening sites (n=1,080). The findings will guide assembly of an optimized and scalable
cessation treatment package that achieves superior cessation outcomes with attention to minimizing burden in
lung cancer screening sites. This study will apply MOST to achieve the following aims: Aim 1: To use a highly
efficient MOST to identify which of four evidence-based tobacco treatment components under consideration
contribute to superior cessation endpoints. The four tobacco treatment components to be tested are: (1)
Motivational Interviewing (MI) (Yes vs. No); (2) NRT Patch (Yes vs. No); 3) NRT Lozenge (Yes vs No); and 4)
Message Framing (Gain vs Loss); Aim 2: To estimate the cost and incremental cost-effectiveness of evidence-
based tobacco treatment components, delivered alone and in combination; Aim 3: Guided by well-established
evaluation and conceptual implementation science frameworks, we will conduct a robust, mixed methods
evaluation of the implementation process and assess factors that may influence implementation and
sustainability for delivering and disseminating effective models for smoking cessation treatment in lung cancer
Lung Cancer Screening and Smoking Cessation Clinical Trials. SCALE (Smoking Cessation within the Context of Lung Cancer Screening) Collaboration.
, 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.
American Journal Of Respiratory And Critical Care Medicine, 2018-01-15 00:00:00.0; 197(2), p. 172-182.