Clinical Topics

Trying to Determine What Leads to Tobacco Cessation in Vets

by U.S. Medicine

August 22, 2019

MINNEAPOLIS—Incidental pulmonary nodules are commonly found on routine chest imaging, but not enough is known about smoking behaviors among patients with IPNs or characteristics of patient-clinician communication that may contribute to these behaviors.

A study in Tobacco Use Insights assessed the association of patient characteristics and communication quality with smoking behaviors and use of tobacco cessation programs among patients with IPNs.1

The Minneapolis VA Healthcare System-led researchers conducted a prospective, repeated-measures, cohort study of current smokers and past-year quitters with IPNs treated within the VA Portland, OR, Health Care System. Participants included patients with newly reported, incidental nodules <3 cm planned for non-urgent computed tomography follow-up.

Study authors defined the primary outcomes as changes in amount smoked and stage of change for tobacco cessation throughout the follow-up period. The small study identified 37 current smokers and nine recent quitters.

By the final visit, eight of 36 (22%) baseline smokers had quit and two of seven (29%) recent quitters had resumed smoking.

Of 40 respondents overall, 23 (58%) reported receiving any tobacco treatment – either recommendation to quit, medication, and/or behavioral treatment—at least once during follow-up.

The study team found no significant associations of high-quality communication, patient distress, self-perceived risk of lung cancer and self-reported clinician-recommended smoking cessation interventions with decrease in amount smoked or positive stage of change.

“Many smokers and recent quitters with IPNs quit during follow-up, though nearly half reported no quit support,” study authors wrote. “We found no association between communication quality or quit support and decreased smoking. The intensity of tobacco treatment offered may have been insufficient to affect behavior.”

Melzer AC, Golden SE, Wiener RS, Iaccarino JM, Slatore CG. A Brief Report of Smoking Behaviors in Patients with Incidental Pulmonary Nodules: Associations with Communication and Risk Perception. Tob Use Insights. 2019 Apr 15;12:1179173X19839059. doi: 10.1177/1179173X19839059. eCollection 2019. PubMed PMID: 31019369; PubMed Central PMCID: PMC6466466.



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