Nicotine & Tobacco Research, 2020, 1484–1491 doi:10.1093/ntr/ntz148 Original Investigation 1484 Received January 24, 2019; Editorial Decision August 10, 2019; Accepted August 15, 2019 © The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. Original Investigation Smoking Cessation in the ITALUNG Lung Cancer Screening: What Does “Teachable Moment” Mean? Francesco Pistelli MD, PhD 1, , Ferruccio Aquilini MSc 1 , Fabio Falaschi MD 2 , Donella Puliti MSc 3 , Cristina Ocello MSc 3 , Andrea Lopes Pegna MD 4 , Francesca Maria Carozzi MSc 5 , Giulia Picozzi MD 6 , Marco Zappa MD 3 , Mario Mascalchi MD, PhD 7 , Eugenio Paci MD, PhD 3, , Laura Carrozzi MD 1,8 on behalf of the ITALUNG Working Group 1 Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy; 2 2nd Radiodiagnostic Unit, Department of Diagnostic Imaging, University Hospital of Pisa, Pisa, Italy; 3 Clinical Epidemiology Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy; 4 Formerly Pneumonology Department, University Hospital Careggi, Florence, Italy; 5 Cancer Prevention Regional Laboratory, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy; 6 Clinical Breast Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy, Florence, Italy; 7 Formerly Clinical Epidemiology Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy; 8 Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa Corresponding Author: Francesco Pistelli, MD, PhD, Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, Via Paradisa, 2, Cisanello, Pisa 56124, Italy. E-mail: f.pistelli@ao-pisa.toscana.it See Acknowledgments for members of ITALUNG Working Group. Abstract Background: Changes in smoking habits and predictors of smoking cessation were examined in the randomized ITALUNG lung cancer screening trial. Methods: In three centers, eligible smokers or ex-smokers (55–69 years, ≥20 pack-years in the last 10 years) were randomized to receive annual invitation for low-dose computed tomography for 4 years or usual care. At invitation, subjects received written information for a free smoking cessa- tion program. Quitting outcome was assessed at year 4. Results: Among participants who completed baseline assessments and year 4 screening, higher quitting (20.8% vs. 16.7%, p = .029) and lower relapse (6.41% vs. 7.56%, p = .50) rates were observed in the active screening group as compared to the usual-care control group. Corresponding figures in the intention-to-treat analysis were as follows: 16.04% versus 14.64% (p = .059) and 4.88% versus 6.43% (p = .26). Quitting smoking was signifi- cantly associated to male gender, lower pack-years, and having pulmonary nodules at base- line. Center-specific analyses showed a threefold statistically significant higher probability to quit associated with participating in the smoking cessation program. A subsample of smokers of the scan group from one center showed higher quitting rates over 12-month follow-up as compared to matched controls from the general population who underwent the same smoking cessation program. Downloaded from https://academic.oup.com/ntr/article/22/9/1484/5553694 by guest on 09 June 2022