2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6ef,Integrating smoking cessation supports into lung cancer screening can improve abstinence rates. However, healthcare decision-makers need evidence of cost-effectiveness to understand the cost/benefit of adopting this approach. To evaluate the cost-effectiveness of smoking cessation interventions, and service delivery, we used a cohort-based Markov model, adapted from previous National Institute for Health and Care Excellence (NICE) guidelines on smoking cessation. This uses long-term epidemiological data to capture the prevalence of the smoking-related illnesses, updated through targeted literature searches as required from the core NICE model, with costs extracted from publicly recognised UK sources. All smoking cessation interventions appeared cost-effective at a threshold of £20 000 per quality-adjusted life year, compared with no intervention or behavioural support alone. Offering immediate smoking cessation as part of lung cancer screening appointments, compared with usual care (onward referral to stop smoking services), was also estimated to be cost-effective with a net monetary benefit of £2198 per person, and a saving of between £34 and £79 per person in reduced workplace absenteeism among working age attendees. Estimated healthcare cost savings were more than four times greater in the most deprived quintile compared with the least deprived, alongside a fivefold increase in quality adjusted life years accrued. Smoking cessation interventions within lung cancer screening are cost-effective and should be integrated, so that treatment is initiated during screening visits. This is likely to reduce overall costs to the health service, and wider integrated care systems, improve quality and length of life, and may lessen health inequalities.31:T93a, Introduction Integrating smoking cessation supports into lung cancer screening can improve abstinence rates. However, healthcare decision-makers need evidence of cost-effectiveness to understand the cost/benefit of adopting this approach. Methods To evaluate the cost-effectiveness of smoking cessation interventions, and service delivery, we used a cohort-based Markov model, adapted from previous National Institute for Health and Care Excellence (NICE) guidelines on smoking cessation. This uses long-term epidemiological data to capture the prevalence of the smoking-related illnesses, updated through targeted literature searches as required from the core NICE model, with costs extracted from publicly recognised UK sources. Results All smoking cessation interventions appeared cost-effective at a threshold of £20 000 per quality-adjusted life year, compared with no intervention or behavioural support alone. Offering immediate smoking cessation as part of lung cancer screening appointments, compared with usual care (onward referral to stop smoking services), was also estimated to be cost-effective with a net monetary benefit of £2198 per person, and a saving of between £34 and £79 per person in reduced workplace absenteeism among working age attendees. Estimated healthcare cost savings were more than four times greater in the most deprived quintile compared with the least deprived, alongside a fivefold increase in quality adjusted life years accrued. Conclusions Smoking cessation interventions within lung cancer screening are cost-effective and should be integrated, so that treatment is initiated during screening visits. This is likely to reduce overall costs to the health service, and wider integrated care systems, improve quality and length of life, and may lessen health inequalities. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Tobacco Use Disorder: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Tobacco Use Disorder (condition). Clinician-written summaries and actionable practice insights. 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Age-stratified analyses suggested associations for smoking initiation and mental health symptoms may be stronger in younger adolescents.","limitations":"Most consistent associations came from large cross-sectional studies, limiting causal inference. Age-stratified high-quality analyses were limited. Long-term consequences of vaping in CYP remain unknown given its relative novelty.","practice_takeaway":"Clinicians should screen adolescent patients — especially younger teens — for vaping given its links to respiratory symptoms, anxiety, depression, and accelerated cigarette uptake. Current evidence supports advocating for stricter regulatory frameworks to reduce youth access to vaping products."}},{"doi":"10.1183/13993003.01013-2026","pmid":"42562594","title":"Statement of the European Respiratory Society on the tobacco endgame","journal_title":"European Respiratory Journal","journal_issn":"0903-1936","published_at":"2026-08-06T00:00:00.000Z","url":"https://doi.org/10.1183/13993003.01013-2026","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-14T13:25:02.734Z","updated_at":"2026-08-14T13:25:02.734Z","tags":[{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"condition","value":"Smoking-Related Disease","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"condition","value":"Tobacco Use Disorder","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"study_design","value":"Position Statement / Expert Opinion","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"warning","value":"Full text was not available for review; summary is based on title, journal, and DOI metadata only — specific policy recommendations within the statement could not be verified.","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"warning","value":"The 'impact_flag' of practice_changing reflects potential policy influence rather than a clinical trial result; this is a judgment call given the authoritative source.","value_numeric":null},{"paper_doi":"10.1183/13993003.01013-2026","tag_type":"warning","value":"The paper is a society position statement published August 2026; no primary data, sample size, or clinical outcomes are reported — several tag fields (e.g., sample size, sex) are omitted as not applicable.","value_numeric":null}],"summaries":{"limitations":"As a society position statement rather than an original research study, it does not provide primary data, control groups, or quantified outcomes from a clinical trial or observational study.","practice_takeaway":"Clinicians should be aware of the ERS's formal advocacy for tobacco endgame policies, which may shape future regulatory frameworks affecting smoking cessation practice across Europe.","what_studied":"This is a position statement from the European Respiratory Society (ERS) outlining its stance on the 'tobacco endgame' — policy strategies aimed at eliminating tobacco use and its harms."}},{"doi":"10.1200/jco-25-02267","pmid":"42441935","title":"Virtual Sustained Tobacco Treatment for Patients With Cancer: A Randomized Controlled Trial (ECOG-ACRIN: EAQ171CD) Within the National Cancer Institute Community Oncology Research Program","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-07-13T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-02267","source_score":64,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-18T13:39:57.659Z","updated_at":"2026-07-18T13:39:57.659Z","tags":[{"paper_doi":"10.1200/jco-25-02267","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"condition","value":"Tobacco Use Disorder","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"generic","value":"nicotine replacement therapy","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"modality","value":"Nicotine Replacement Therapy","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"modality","value":"Telehealth Behavioral Counseling","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"sample_size","value":"n=306","value_numeric":306},{"paper_doi":"10.1200/jco-25-02267","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"warning","value":"Abstinence was measured by 7-day point prevalence self-report without biochemical verification, which may overestimate true quit rates.","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"warning","value":"No specific brand of NRT was named; NRT type and formulation were not detailed in the abstract.","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"warning","value":"NRT was provided free only to the VST group, making it difficult to isolate the independent contribution of counseling vs. medication access to the treatment effect.","value_numeric":null},{"paper_doi":"10.1200/jco-25-02267","tag_type":"warning","value":"The sample was predominantly White (86.3%) and female (70.9%), so results may not generalize to more diverse or male-predominant cancer populations.","value_numeric":null}],"summaries":{"what_studied":"This RCT compared virtual sustained telehealth counseling plus free NRT (VST, up to 11 sessions over ~6 months) versus referral to the NCI quitline (enhanced usual care, EUC) for smoking cessation in 306 recently diagnosed cancer patients across 37 community oncology sites (August 2019–December 2022).","key_result":"6-month, 7-day point abstinence was **28.4% (42/148) with VST vs. 14.7% (21/143) with EUC** — nearly doubling quit rates. Engagement was high: 80.8% of VST participants attended counseling and 85.7% received NRT. More sessions (>8 vs. <5) predicted quitting (P=.005). Incremental cost per quit was $7,724 USD.","limitations":"- Sample was 86.3% White and 70.9% female, limiting generalizability to more diverse populations.\n- Abstinence was self-reported (7-day point prevalence), not biochemically verified.\n- NRT was provided free to VST participants but not EUC participants, which may inflate the treatment effect beyond counseling alone.","practice_takeaway":"Offer recently diagnosed cancer patients sustained telehealth tobacco counseling plus NRT — it nearly doubles 6-month quit rates compared to quitline referral alone and is feasible in community oncology settings. Encourage patients to complete more than 8 sessions, as higher engagement is linked to greater cessation success."}},{"doi":"10.1016/j.jtho.2026.104071","pmid":"42409118","title":"Cytisine for Smoking Cessation Within a Lung Cancer Screening Program: Results From the Italian RISP Trial","journal_title":"Journal of Thoracic Oncology","journal_issn":"1556-0864","published_at":"2026-07-06T00:00:00.000Z","url":"https://doi.org/10.1016/j.jtho.2026.104071","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-15T13:26:11.078Z","updated_at":"2026-07-15T13:26:11.078Z","tags":[{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"condition","value":"Lung Cancer Screening","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"condition","value":"Tobacco Use Disorder","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"generic","value":"cytisine","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"modality","value":"Partial Nicotinic Agonist","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"sample_size","value":"n=3548","value_numeric":3548},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"warning","value":"The primary abstinence endpoint is self-reported over a 2-week post-program window; long-term quit rates are not reported, limiting clinical translation.","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"warning","value":"The study design is a prospective cohort/sub-study within the RISP trial, not a randomized controlled trial — the cytisine vs. counseling-alone comparison is observational and subject to confounding by indication (cytisine users had higher motivation and smoking exposure at baseline).","value_numeric":null},{"paper_doi":"10.1016/j.jtho.2026.104071","tag_type":"warning","value":"Total sample size reported reflects participants who pursued a cessation program (n=3,548); the overall trial enrolled 10,191, but only 1,375 received cytisine — readers should note the denominator context when interpreting uptake rates.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated cytisine (1.5 mg, escalating/de-escalating schedule) vs. counseling alone for smoking cessation in active smokers enrolled in the Italian RISP lung cancer screening trial, with a primary endpoint of self-reported continuous abstinence in the 2 weeks after completing the cessation program.","key_result":"Smoking cessation rate was 50.1% with cytisine vs. 8.1% with counseling alone (adjusted OR 14.53, 95% CI 11.67–18.08, p<0.05); cytisine users also had greater cigarette reduction (23.4% vs. 10.0%, p<0.0001). Efficacy and toxicity were similar in adults ≥65 years (n=428).","limitations":"Primary endpoint relied on self-reported abstinence without biochemical verification for all participants; the cessation program was optional and uptake was voluntary, introducing selection bias (cytisine users had higher pack-years and motivation at baseline); short follow-up window (2 weeks post-program) limits conclusions about long-term abstinence.","practice_takeaway":"Integrating cytisine into a lung cancer screening program can yield cessation rates roughly 6 times higher than counseling alone, and the drug appears effective and safe in adults aged ≥65. Clinicians should counsel women about a higher risk of abdominal discomfort, and monitor for nausea and insomnia, which together drive most of the 15% dropout rate."}},{"doi":"10.1093/jnci/djag102","pmid":"42287080","title":"Implementation of smoking cessation interventions in real-world lung cancer screening: a RE-AIM–guided scoping review","journal_title":"JNCI: Journal of the National Cancer Institute","journal_issn":"0027-8874","published_at":"2026-06-09T00:00:00.000Z","url":"https://doi.org/10.1093/jnci/djag102","source_score":25,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-18T13:24:24.215Z","updated_at":"2026-06-18T13:24:24.215Z","tags":[{"paper_doi":"10.1093/jnci/djag102","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"condition","value":"Lung Cancer","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"condition","value":"Tobacco Use Disorder","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"modality","value":"Behavioral Support","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"modality","value":"Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"modality","value":"Smoking Cessation Intervention","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"sample_size","value":"n=55","value_numeric":55},{"paper_doi":"10.1093/jnci/djag102","tag_type":"study_design","value":"Scoping Review","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"warning","value":"Level of evidence assigned as 3 (scoping review/systematic review without meta-analysis); this is an approximation as scoping reviews do not fit neatly into standard hierarchies.","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"warning","value":"Sex of participants is not reported in the abstract or results; sex tag omitted.","value_numeric":null},{"paper_doi":"10.1093/jnci/djag102","tag_type":"warning","value":"The full text provided appears to be a Lung Cancer Policy Network report ('Closing the gap') rather than the JNCI scoping review article cited in the metadata; the abstract and results sections do match the JNCI paper. Summaries and tags are based on the abstract/results, as the body text belongs to a different document.","value_numeric":null}],"summaries":{"what_studied":"This RE-AIM–guided scoping review identified and characterized real-world (nontrial) smoking cessation interventions integrated into lung cancer screening (LCS) programs from 2013 onward, searching 6 databases and grey literature sources through February 2025.","key_result":"Across 55 unique studies (84% from the US), behavioral support was described in 96% and pharmacological interventions in 58%. Opt-out referral to embedded programs showed consistently high uptake. More intensive (group/multicomponent) approaches had higher cessation rates. However, program-level data were sparse: provider readiness to adopt reported in only 7% of studies, time/cost data in 5%, and sustained delivery data in 4%.","limitations":"- Heavy US geographic skew (84%) limits global generalizability.\n- Program-level implementation factors (adoption, maintenance, cost) were rarely reported, making it difficult to assess scalability.\n- As a scoping review, it does not pool effect sizes or formally grade evidence quality.","practice_takeaway":"Embed smoking cessation as a core component of LCS programs—not an add-on—using opt-out referral to maximize uptake. Future programs should systematically collect and report adoption, cost, and sustainability data to build a scalable, real-world evidence base."}},{"doi":"10.1038/s41533-026-00518-1","pmid":"42049792","title":"Female smokers’ perspectives on tobacco use and smoking cessation: a qualitative study guided by health belief model","journal_title":"npj Primary Care Respiratory Medicine","journal_issn":"2055-1010","published_at":"2026-04-28T00:00:00.000Z","url":"https://doi.org/10.1038/s41533-026-00518-1","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:18.481Z","updated_at":"2026-05-07T22:50:18.481Z","tags":[{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"condition","value":"Smoking Cessation","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"condition","value":"Tobacco Use Disorder","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"modality","value":"Behavioral Intervention","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"sample_size","value":"n=14","value_numeric":14},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"study_design","value":"Qualitative Study","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"warning","value":"No pharmacological or clinical interventions were assessed; study focuses solely on patient perspectives and attitudes.","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"warning","value":"Sample size of 14 is very small; findings are hypothesis-generating rather than confirmatory.","value_numeric":null},{"paper_doi":"10.1038/s41533-026-00518-1","tag_type":"warning","value":"Study conducted in Singapore — sociocultural context (stigma, family dynamics) may limit direct applicability to other settings.","value_numeric":null}],"summaries":{"what_studied":"This qualitative study explored the perspectives of 14 female smokers (aged 21–59) in a Singapore primary care setting on tobacco use and smoking cessation, guided by the Health Belief Model (HBM) via semi-structured in-depth interviews conducted February 2024–February 2025.","key_result":"Five themes emerged: perceived susceptibility (appearance, health risks to self and children), perceived severity (cardiorespiratory disease, premature mortality, social stigma), perceived benefits of quitting (health, family relationships, finances), perceived barriers (psychosocial and emotional), and cues to action (public health messaging, family encouragement, life-stage transitions).","limitations":"Very small sample (n=14) from a single primary care site in Singapore limits generalisability; all interviews conducted in English, potentially excluding non-English-speaking smokers; purposive sampling may not capture the full spectrum of female smokers.","practice_takeaway":"Cessation support for women should go beyond standard approaches—address emotional and psychosocial barriers, leverage family and social networks, and use life-stage transitions (e.g., pregnancy, parenthood) as teachable moments. A gender-responsive, multifaceted strategy that builds self-efficacy is likely to improve quit rates in female smokers."}},{"doi":"10.1200/jco-25-01815","pmid":"41740088","title":"National Quality Improvement Initiative to Increase Smoking Cessation Assistance in Commission on Cancer Programs and National Accreditation Program for Breast Centers","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-02-25T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-01815","source_score":28,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-04T13:23:45.768Z","updated_at":"2026-06-04T13:23:45.768Z","tags":[{"paper_doi":"10.1200/jco-25-01815","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"condition","value":"Tobacco Use Disorder","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"modality","value":"Behavioral Counseling","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"modality","value":"Smoking Cessation Counseling","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"sample_size","value":"n=446015","value_numeric":446015},{"paper_doi":"10.1200/jco-25-01815","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"study_design","value":"Quality Improvement Study","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"warning","value":"Current smoking rate of 11.8% is lower than general population estimates, suggesting possible under-identification of smokers in participating programs.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"warning","value":"No randomized control arm — observed improvements cannot be fully attributed to the QI intervention versus secular trends or national policy changes.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01815","tag_type":"warning","value":"Sample size tag reflects total patients reported across programs; the QI intervention unit was programs (n=324), not individual patients.","value_numeric":null}],"summaries":{"what_studied":"A national quality improvement (QI) initiative ('Beyond ASK') evaluated whether accredited cancer programs could increase smoking cessation assistance for newly diagnosed cancer patients using Plan-Do-Study-Act methodology across 324 programs over 12 months (January 2023–January 2024).","key_result":"Among 446,015 newly diagnosed cancer patients, 11.8% were current smokers; the mean cessation assist rate rose from 48.0% at baseline to 67.5% at final survey (absolute increase ~19.5 percentage points). Full adoption was reported by 65.4% of programs, and all measured delivery modes increased significantly (e.g., in-office brief counseling: 33.9% → 65.8%, P = .0002).","limitations":"No control group, so secular trends cannot be ruled out. Self-reported survey data introduces risk of social desirability bias. Current smoking prevalence of 11.8% may reflect under-identification rather than true prevalence.","practice_takeaway":"Cancer programs can meaningfully scale smoking cessation assistance within one year using structured QI tools, educational webinars, and EHR guidance — making cessation support at diagnosis a practical standard of care. Clinicians should ensure every newly diagnosed cancer patient is screened for smoking and offered at least brief in-office counseling."}},{"doi":"10.1136/thorax-2024-222815","pmid":"41494909","title":"Health economic model to evaluate the cost-effectiveness of smoking cessation services integrated within lung cancer screening in the United Kingdom","journal_title":"Thorax","journal_issn":"0040-6376","published_at":"2026-01-07T00:00:00.000Z","url":"https://doi.org/10.1136/thorax-2024-222815","source_score":9,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-12","doi":"10.1136/thorax-2024-222815","days":"14","issn":"0040-6376","rank":"7","field":"Clinical Medicine","score":"9","category":"Respiratory System","categories":["Respiratory System"],"_categories":["Respiratory System"]},"pubmed":{"doi":"10.1136/thorax-2024-222815","title":"Health economic model to evaluate the cost-effectiveness of smoking cessation services integrated within lung cancer screening in the United Kingdom.","journal":"Thorax","methods":"","results":"All smoking cessation interventions appeared cost-effective at a threshold of £20 000 per quality-adjusted life year, compared with no intervention or behavioural support alone. Offering immediate smoking cessation as part of lung cancer screening appointments, compared with usual care (onward referral to stop smoking services), was also estimated to be cost-effective with a net monetary benefit of £2198 per person, and a saving of between £34 and £79 per person in reduced workplace absenteeism among working age attendees. Estimated healthcare cost savings were more than four times greater in the most deprived quintile compared with the least deprived, alongside a fivefold increase in quality adjusted life years accrued.","abstract":"$30","keywords":["Health Economist","Lung Cancer","Smoking"],"pubmed_id":"41494909","conclusions":"","publication_date":"2026-01-07T00:00:00"},"crossref":{"DOI":"10.1136/thorax-2024-222815","URL":"https://doi.org/10.1136/thorax-2024-222815","ISSN":["0040-6376","1468-3296"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.1136/thorax-2024-222815","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"thorax-2024-222815","type":"journal-article","issue":null,"score":1,"title":["Health economic model to evaluate the cost-effectiveness of smoking cessation services integrated within lung cancer screening in the United Kingdom"],"author":[{"given":"Matthew","family":"Evison","sequence":"first","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"},{"name":"Manchester Academic Health Science Centre (MAHSC), Faculty of Biology, Medicien & Health, University of Manchester, Manchester, UK"}]},{"given":"Rebecca","family":"Naylor","sequence":"additional","affiliation":[{"name":"Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"}]},{"given":"Robert","family":"Malcolm","sequence":"additional","affiliation":[{"name":"Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"}]},{"given":"Hayden","family":"Holmes","sequence":"additional","affiliation":[{"name":"Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"}]},{"given":"Matthew","family":"Taylor","sequence":"additional","affiliation":[{"name":"Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"}]},{"given":"Rachael L","family":"Murray","sequence":"additional","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK"}]},{"given":"Matthew EJ","family":"Callister","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}]},{"given":"Nicholas S","family":"Hopkinson","sequence":"additional","affiliation":[{"name":"Imperial College London, National Heart and Lung Institute, London, UK"}]},{"given":"Sanjay","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Institute for Lung Health, Department of Respiratory Medicine, Glenfield Hospital, Leicester, UK"}]},{"given":"Hazel","family":"Cheeseman","sequence":"additional","affiliation":[{"name":"Action on Smoking and Health, London, UK"}]},{"given":"David","family":"Baldwin","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"}]},{"given":"Zoe","family":"Merchant","sequence":"additional","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"}]},{"given":"Patrick","family":"Goodley","sequence":"additional","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"},{"name":"Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK"}]},{"given":"Alaa","family":"Alsaaty","sequence":"additional","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"}]},{"given":"Haval","family":"Balata","sequence":"additional","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"}]},{"given":"Phil","family":"Crosbie","sequence":"additional","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"},{"name":"Division of Immunology, Immunity to Infection and Respiratpry Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK"}]},{"given":"Richard","family":"Booton","sequence":"additional","affiliation":[{"name":"Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"}]}],"funder":[{"id":[{"id":"10.13039/100031315","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100031315","name":"AstraZeneca UK","award":["no award/grant number"],"award-info":[{"award-number":["no award/grant 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Comparators included no intervention or behavioural support alone, and immediate treatment at the screening visit versus onward referral.","key_result":"All smoking cessation interventions were cost-effective at a £20,000 per QALY threshold versus no intervention or behavioural support alone. Starting cessation treatment during screening had a net monetary benefit of £2,198 per person versus usual care, reduced workplace absenteeism costs by £34–£79 per working-age attendee, and produced >4-fold higher healthcare cost savings and ~5-fold more QALYs in the most versus least deprived quintile.","practice_takeaway":"Offer smoking cessation during lung cancer screening and start treatment at the visit; in this UK model it was cost-effective with a positive net monetary benefit. Expect larger health and cost gains in more deprived groups."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Tobacco Use Disorder"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Tobacco Use Disorder"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Tobacco Use Disorder"}}}]]

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