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Observational Study
. 2025 Jul 22;27(8):1412-1419.
doi: 10.1093/ntr/ntaf010.

Impact of Low-Dose Computed Tomography Findings on Cigarette Smoking Cessation Among High-Risk Adults Participating in Lung Cancer Screening

Evangelos Katsampouris  1 , Amyn Bhamani  2 , Fanta Bojang  3 , Jennifer L Dickson  2 , Helen Hall  2 , Carolyn Horst  2 , Priyam Verghese  2 , Andrew Creamer  2 , Ruth Prendecki  2 , Chuen Khaw  2 , Sophie Tisi  2 , John McCabe  2 , Kylie Gyertson  3 , Anne-Marie Hacker  4 , Laura Farrelly  4 , Neal Navani  2   3 , Allan Hackshaw  4 ; SUMMIT Consortium; Sam M Janes  2 , Samantha L Quaife  1 , Sam M Janes, Jennifer L Dickson, Carolyn Horst, Sophie Tisi, Helen Hall, Priyam Verghese, Andrew Creamer, Thomas Callender, Ruth Prendecki, Amyn Bhamani, Mamta Ruparel, Allan Hackshaw, Laura Farrelly, Jon Teague, Anne-Marie Mullin, Kitty Chan, Rachael Sarpong, Malavika Suresh, Samantha L Quaife, Arjun Nair, Anand Devaraj, Kylie Gyertson, Vicky Bowyer, Ethaar El-Emir, Judy Airebamen, Alice Cotton, Kaylene Phua, Elodie Murali, Simranjit Mehta, Janine Zylstra, Karen Parry-Billings, Columbus Ife, April Neville, Paul Robinson, Laura Green, Zahra Hanif, Helen Kiconco, Ricardo McEwen, Dominique Arancon, Nicholas Beech, Derya Ovayolu, Christine Hosein, Sylvia Patricia Enes, Qin April Neville, Jane Rowlands, Aashna Samson, Urja Patel, Fahmida Hoque, Hina Pervez, Sofia Nnorom, Moksud Miah, Julian McKee, Mark Clark, Jeannie Eng, Fanta Bojang, Claire Levermore, Anant Patel, Sara Lock, Rajesh Banka, Angshu Bhowmik, Ugo Ekeowa, Zaheer Mangera, William M Ricketts, Neal Navani, Terry O'Shaughnessy, Charlotte Cash, Magali Taylor, Samanjit Hare, Tunku Aziz, Stephen Ellis, Anthony Edey, Graham Robinson, Alberto Villanueva, Hasti Robbie, Elena Stefan, Charlie Sayer, Nick Screaton, Navinah Nundlall, Lyndsey Gallagher, Andrew Crossingham, Thea Buchan, Tanita Limani, Kate Gowers, Kate Davies, John McCabe, Joseph Jacob, Karen Sennett, Tania Anastasiadis, Andrew Perugia, James Rusius, Geoff Bellingan, Maureen Browne, Eleanor Hellier, Catherine Nestor
Collaborators, Affiliations
Observational Study

Impact of Low-Dose Computed Tomography Findings on Cigarette Smoking Cessation Among High-Risk Adults Participating in Lung Cancer Screening

Evangelos Katsampouris et al. Nicotine Tob Res. .

Abstract

Introduction: Integrating effective smoking cessation strategies for individuals undergoing lung cancer screening stands to significantly increase the impact of lung screening programmes. We assessed the impact of low-dose computed tomography (LDCT) findings on smoking cessation among high-risk adults who currently smoked.

Aims and methods: 13 035 individuals, aged 55-77 years, attended a lung health check appointment, as part of a prospective observational cohort study (the SUMMIT Study), prior to undergoing a baseline LDCT scan. Logistic regressions examined the likelihood of smoking cessation at a 1-year follow-up appointment and its association with LDCT findings.

Results: 12.6% (n = 647/5135) of individuals self-reported smoking cessation at 1-year follow-up. Higher odds of quitting were found in those receiving indeterminate pulmonary nodule findings requiring a 3-month interval LDCT (aOR = 1.27; 1.01, 1.61), those with urgent findings requiring referral to secondary care (aOR = 1.55; 1.05, 2.32), and those with a possible new chronic obstructive pulmonary disease diagnosis (aOR = 1.60; 1.23, 2.06), compared to those receiving no actionable LDCT findings. Older age, Asian ethnic background, current high smoking intensity, motivation and number of quit attempts, and low nicotine dependence were associated with increased odds of quitting.

Conclusions: Individuals currently smoking, at high lung cancer risk, participating in LDCT screening, and receiving incidental findings requiring a 1-year interval LDCT or primary care follow-up might therefore need additional behavioral support to quit. Tailored communication strategies depending on the severity of the LDCT findings, including additional behavioral support for those with less clinical concerning or negative findings, could increase quit rates and reduce smoking-related morbidity.

Implications: This study reports high odds of self-reported complete smoking cessation in adults who currently smoked after receiving their LDCT findings. Though the impact of specific types of LDCT findings on smoking cessation was positive for high lung cancer risk individuals, reception of incidental findings could potentially be perceived as less severe to encourage individuals who currently smoked to quit. Clearly communicating the severity of LDCT findings along with the delivery of behavioral smoking cessation support targeted to high-risk individuals may increase their chances of complete smoking cessation and reduce lung cancer mortality.

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Conflict of interest statement

SUMMIT is sponsored and conducted by University College London and funded by GRAIL, LLC through a research grant awarded to SMJ as principal investigator. AB, PV, AC, RP, CK, JLD, CH, ST, HH, and JM were or are employed by University College London (UCL) through SUMMIT Study funding provided by GRAIL, LLC. SLQ collaborates on the SUMMIT study and has received an honorarium from Elsevier for writing a book chapter and payment for a presentation/website context piece from Global Lung Cancer Coalition. SMJ has received honoraria for advisory board work from Astra Zeneca, BARD1 Bioscience, Achilles Therapeutics, Jansen and Optellum, support for travel to meetings from Astra Zeneca and Takeda, grant income from Owlstone and GRAIL, LLC, and share options from Optellum. AH has received support for travel and an honorarium for an advisory board meeting for GRAIL LLC, consulting fees from Evidera (for a GRAIL-initiated project), and has previously owned shares in Illumina. NN reports honoraria for non-promotional educational talks or advisory boards from Amgen, Astra Zeneca, Boehringer Ingelheim, Bristol Myers Squibb, EQRx, Fujifilm, Guardant Health, Intuitive, Janssen, Lilly, Merck Sharp & Dohme, Olympus, and Roche. NN is a member of the British Thoracic Oncology Group steering committee, director of UK Lung Cancer Coalition, and Clinical Director of National Lung Cancer Audit. All authors perceive that these disclosures pose no academic conflict for this study and declare no other relationships or activities that could appear to have influenced the submitted work.

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