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Pyng Lee



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    MS16 - The Interventional Pulmonologist's Contribution to Screen-Detected Nodules: From Diagnosis to Treatment (ID 79)

    • Event: WCLC 2019
    • Type: Mini Symposium
    • Track: Interventional Diagnostics/Pulmonology
    • Presentations: 1
    • Now Available
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      MS16.06 - Smoking Cessation in a Pulmonary Clinic (Now Available) (ID 3535)

      14:30 - 16:00  |  Presenting Author(s): Pyng Lee

      • Abstract
      • Presentation
      • Slides

      Abstract

      The National Lung Screening Trial (NLST) demonstrated 20% reduction in lung cancer mortality with low-dose computed tomography (LDCT) screening of current and former smokers. While LDCT screening improves patient outcomes, quitting smoking remains the most effective intervention in reducing lung cancer death. Promoting smoking cessation is an essential component of lung cancer screening program. In the US, Medicare mandates tobacco cessation interventions for current smokers to receive reimbursement for LDCT screening. Quitting smoking would improve mortality benefit and cost-effectiveness of LDCT screening. It is estimated that doubling the quit rate in screening-eligible patients would decrease LCDT screening cost by half, and a simulation model has suggested that addition of behavioral cessation intervention to LDCT screening could reduce the cost per QALY by 25%, and by 50% with pharmacologic therapy. While LDCT screening represents a valuable opportunity to deliver smoking cessation interventions, an aggressive two-pronged approach is necessary to increase success with smoking cessation for this patient population. Counseling is essential to motivate patients to quit by identifying potential barriers and obstacles as well as in formulating an individualized quit plan. Counseling on its own is insufficient to tackle physiologic dependence of smoking. I will review the 5As approach (Ask about smoking, Advise to quit, Assess readiness to quit, Assist with tobacco dependence treatment, and Arrange follow-up) as well as available pharmacomtherapies to help patients achieve tobacco abstinence.

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