No Additional Effect of a Personalized Tobacco Treatment Intervention on Smoking Abstinence in Individuals Eligible for Lung Cancer Screening: Brief Report of a Randomized Trial.

To determine whether personalized gain-framed messaging and biomarker feedback related to tobacco cessation/reduction decreases smoking behavior in patients undergoing or eligible for lung cancer screening.Between 2016 and 2020, 188 patients were enrolled in a two-phase sequential randomized controlled trial. Phase 1 examined whether standard of care (5 in-person counselling sessions and 8-weeks of nicotine patch) plus gain-framed messaging (SC+GFM) vs standard of care (SC) would increase 8-week biochemically-verified smoking cessation rates. In 143 participants randomized in phase 2, we tested whether feedback on smoking-related biomarkers would reduce 6-month self-reported number of cigarettes smoked per day compared to a no feedback control. Chi-square test and mixed effects repeated measures analyses were used to examine group differences.Participants were 62.5+5.6 (mean + standard deviation) years of age, had a 50.3+21 pack-year smoking history and were smoking 16.9+9.9 cigarettes per day. At 8 weeks, there was no difference in quit rates between those randomized to SC+GFM (n=15/93, 16.1%) and those randomized to SC (n=16/95, 16.8%), with P=0.90. At the 6-month post randomization follow-up, number of cigarettes smoked per day was similar in the feedback (least-squares mean:7.5, 95% CI: 6.0, 9.1) and no feedback arms (7.7, 95% CI: 6.2, 9.3), with P=0.87.Gain-framed messaging and health feedback did not significantly improve quit rates relative to comprehensive standard care. However, the overall program achieved clinically meaningful smoking quit rates in this older high pack-year cohort, highlighting the importance of intensive tobacco treatment for lung cancer screening patients.