Abstract
Introduction: Low dose CT screening (LDCT) for lung cancer may be a teachable moment for smoking cessation (SC),but no pharmacological intervention has been performed in LDCT trials.
Aim: A three-month Varenicline course in a group of patients (Pts) enrolled in the Milan Lung Detection Trial,with biochemical verification of the smoking status.
Matherials and Methods: 187 Pts received Varenicline;43% and 32% of them were allocated to 1 vs 2-year LDCT,while 25% to minimal SC advice and no LDCT (Ctrl).Lung function testings (PFTs),exhaled carbon monoxide (CO) and side effects were longitudinally recorded.Pts with a CO ≤6 ppm were considered abstinent.Descriptive statistic as well as parametric and non-parametric tests were performed.
Results: Pts were 61±5.2 years old,with a mean CO of 16.3±7.9 ppm,a smoking history of 22.2±21.9 pack/years,a Fagerström test of 7.5±2.2 points and a slight decrease in mean FEV1% (84.1±14.6).Global quit rates were 51.7%, 50.7% and 41.8% on month 1,3,6 respectively;quit rates were equal in LDCT subgroups but they were lower in the subgroup of Pts with FEV1%≥70<80%. Among non-quitters, those in the LDCT active arms, as well as those with a FEV1%≥70<80% showed higher CO values than Ctrl at baseline and along the study. Side effects were presents in 28.4% of Pts and therapy discontinuation happened in 20.4% of cases.
Conclusion: A pharmacological intervention within a LDCT trial can lead to rewarding percentages of SC. Mild function impairment poses a higher risk of continuative smoking, while being in an active LDCT arm may result in stronger smoking intensity over time.
- © 2012 ERS