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Smoking Cessation and Lung Cancer Screening Programs: The Rationale and Method to Integration
Published in Ayman El-Baz, Jasjit S. Suri, Lung Imaging and CADx, 2019
Meghan Cahill, Brooke Crawford O'Neill, Kimberly Del Mauro, Courtney Yeager, Bradley B. Pua
While the potential for integration of these two interventions is obvious, understanding the cost-effectiveness of such is essential to rationalize implementation. By utilizing an actuarial model based on the screening efficacy of previous, well-established studies, Villanti et al. [46] compared the cost-effectiveness of annual lung cancer screening with varying intensities of smoking cessation interventions. This study concluded that while LDCT screening in high-risk populations was highly cost effective on its own, the addition of cessation interventions improved program cost-effectiveness. Whereas the accepted cost-effectiveness threshold for screening in 2012 was $109,000 per quality-adjusted life year (QALY) gained, the estimated cost per QALY gained for screening alone was $28,240. With the addition of smoking-related behavioral therapy or behavior therapy plus pharmacotherapy, the estimated cost per QALY gained decreased to $23,185 and $16,718, respectively.
The World Trade Center Health Program: Smoking cessation
Published in Archives of Environmental & Occupational Health, 2023
Gerald Lilly, Geoffrey M. Calvert
Given the hazards of smoking, it is important to promote smoking cessation among patients who smoke. Even for patients with smoking-related disease, it is often not too late to experience the benefits of quitting.5 The USPSTF recommends that smoking cessation services be offered to all currently smoking adults.6 Smoking cessation medications and behavioral counseling increase the likelihood of successfully quitting smoking, particularly when used in combination.7 Systematic reviews found that participants who received a combination of pharmacotherapy and behavioral counseling had higher cessation rates at 6 months compared with control participants who received only pharmacotherapy and, in some cases, brief advice on quitting.8 There are 7 FDA-approved smoking cessation medications, 3 of which are available over-the-counter.5 Behavioral counseling can be delivered in a variety of formats, including individual, group, and telephone, all of which have been demonstrated to be effective.5 Additionally, research shows that web-based and mobile phone text messaging interventions can effectively help adults quit smoking.5,9
Proactive outreach smoking cessation program for Chinese employees in China
Published in Archives of Environmental & Occupational Health, 2018
Man Ping Wang, Yi Nam Suen, William Ho Cheung Li, Oi Sze Lau, Tai Hing Lam, Sophia Siu Chee Chan
Smoking causes substantial health and economic losses1 in Hong Kong, the most westernized and developed city in China, with the lowest daily smoking prevalence (10.5%) in the world (USA: 15.1%; Europe: 28%; China: 28.1%; Thailand: 24.0%; Japan: 19.3%).2–5 There are smoking cessation (SC) services in Hong Kong that provide evidence-based SC intervention including telephone, face-to-face, and group counseling; doctor-prescribed SC medications; and nicotine replacement therapy. These require smokers to self-initiate and despite being offered free of charge, very few (3%) smokers utilize these.4 Workplace SC service is warranted as many smokers can be reached and retained effectively.6 Various workplace SC interventions targeting smokers individually have beeen studied. These include group or individual counseling, self-help interventions, pharmacological therapy, and social support; they have also targeted the workplace as a whole. Environmental support for not smoking, incentives, and multiple interventions have been examined for their effects on smoking abstinence, reduction, or change in the stage of behavior.7 Group therapy, individual counseling, and multiple interventions were found to be more effective than self-help interventions in increasing quitting outcomes.7 Notably, most of these studies were conducted in Western countries.7,8 To our knowledge, among the few Asian studies about workplace SC, most were conducted in Japan; only 1 randomized controlled trial (RCT) was conducted in China (Shanghai) and it only examined the tobacco control program consisting of single SC intervention (group therapy using stage theory of organizational change).8,9 None tested the SC program with multiple elements in Chinese workplaces.