Abstract
Background
Lung cancer is the leading cause of cancer-related deaths globally, with tobacco use as the primary risk factor. Lung cancer screening represents a potential point of care intervention to promote smoking cessation. This study evaluates the impact of participating in the LUCIA lung-screening program on smoking cessation rates and assesses whether Low-Dose CT (LDCT) findings influence the decision to quit.
Methods
We analyzed smoking habits within the LUCIA prospective cohort in the Basque Country (n = 1,486; age 40-80). All participants underwent baseline LDCT. Smoking status was assessed at baseline, 6 months, and 12 months. We compared LDCT findings (emphysema, interstitial features, pleural abnormalities and Lung-RADS categories) between those who achieved cessation and those who continued smoking using Chi-square tests.
Results
The cohort (59% female, median age 54) consisted of 47.4% ex-smokers, 25.9% never-smokers, and 26.6% (n = 396) smokers. Among baseline smokers, the cessation rate was 9.1% (n = 36) at 6 months, increasing to 15.2% (n = 60) at 12 months (p < 0.001). At 12 months, quitters (n = 60) and persistent smokers (n = 260) showed similar distributions of emphysema (33.3% vs 23.5%), interstitial features (6.7% vs 10.8%), and pleural abnormalities (6.7% vs 6.2%). Lung-RADS 1-2 nodules were present in 38.3% of quitters and 36.5% of persistent smokers. No significant association was found between the presence of at least one CT abnormality and smoking cessation at 12 months (58.3% of quitters had findings vs 55% of persistent smokers; p = 0.639).
Conclusions
The study demonstrates a significant smoking cessation rate at 1 year. However, the absence of a correlation between LDCT abnormalities and quitting success suggests that cessation was driven by the program’s participation and counseling rather than the specific radiologic findings. Participation in screening programs, regardless of individual results, serves as a key determinant for smoking cessation
Key messages
• Participation in a lung cancer screening program led to a 15.2% smoking cessation rate at 12 months, independent of LDCT findings.
• The screening process itself, rather than the presence of subclinical lung damage, acts as the primary driver for tobacco cessation.