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Integrated Care Enhances Smoking Cessation Success: The Role of Medication and Counseling
- Integrated care that includes medication and tobacco treatment counseling can enhance the probability of smoking cessation among smokers who undergo lung cancer screening, according to a recent study published in the JAMA Internal Medicine. The study conducted by researchers at the University of Texas MD Anderson Cancer Center shows that structured support systems augment smoking cessation among people preparing for lung cancer screening. Participants who received integrated care had a two-fold increase in the likelihood of quitting smoking compared to other cessation approaches, with over 30% remaining smoke-free six months after commencing the program.
- Given that tobacco usage is a primary risk factor that contributes to the majority of lung cancer diagnoses in the US, the study emphasizes the need for effective smoking cessation interventions that can potentially save lives. The researchers urge healthcare providers equipped to deliver integrated care to expedite those services to improve smoking cessation efforts and foster better health outcomes for their patients.
- The study involved 630 people recruited from the Houston area, aged at least 50 years and with a reported median tobacco consumption of 20 cigarettes daily, divided into three treatment cohorts. The first group received a quitline referral combined with nicotine replacement therapy (NRT), and the second group received a quitline referral augmented by NRT. The third group received integrated care that combined pharmacotherapy and counseling from a dedicated team of tobacco specialists.
- At the three-month and six-month follow-ups, the integrated care (IC) cohort had higher quit rates at 37.1% and 32.4%, respectively, compared to the other two groups. The study revealed the importance of an integrated approach to smoking cessation, which targeted both pharmacological and behavioral support needs, to enhance the chances of successful quitting.
- The study was funded by the National Cancer Institute, MD Anderson Lung Cancer Moon Shot, the State of Texas Permanent Health Funds, and Pfizer Pharmaceuticals. The researchers suggest that the integrated care approach can be well-implemented in other clinical settings, such as post-traumatic stress disorder clinics or among patients with other comorbid conditions such as cancer, cardiovascular disease, or diabetes.
- The study has limitations as the participant population was predominantly white, raising questions about generalizing results across diverse demographic groups. The absence of carbon monoxide (CO) abstinence verification post-study initiation due to COVID-19 restrictions is a challenge, although comparable results were derived for sub-samples with and without verification.
- The study underscores the importance of an integrated approach to smoking cessation, and its findings can shape future clinical practice and public health policies aimed at reducing smoking prevalence and lung cancer incidences.
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