Radiographer-led smoking cessation intervention

Background

Smoking cessation interventions with low dose CT (LDCT) lung cancer screening have the potential to almost double the relative risk reduction in lung cancer mortality and improve cost effectiveness. Radiographers are uniquely placed to provide advice in this setting, but require support and training to do so.

The proposed study will develop and pilot an intervention and training package to enable radiographers to deliver smoking cessation advice at lung cancer screening. The findings from this study will inform a randomised controlled trial to test the effectiveness of this approach for promoting quit attempts among patients undergoing LDCT screening for lung cancer.

There has been little research on how radiographers view their potential role in health promotion, but a lack of knowledge and training have been identified as barriers. Exploring both radiographer and patient experiences of delivering and receiving the intervention will help to ensure the proposed intervention is acceptable and has real potential to be included in any future lung screening programme.

Dr. Beeken and Dr Woznitza, University of Leeds

What is the problem to be addressed?

There is strong evidence that combining advice on how to quit smoking with lung cancer screening could reduce the number of lung cancer deaths more than screening alone.

Few studies have tested the delivery of smoking cessation interventions at lung cancer screening. Smokers in this setting are likely to have smoked for a long time and may therefore find quitting particularly difficult.

Studies to-date have focused on self-help approaches or interventions delivered over the phone, with only modest results. In-person approaches may achieve better results.

We asked 459 UK adults likely to be eligible for lung cancer screening when they would prefer to receive advice, and most said they would like advice to be given at the appointment itself.

Radiographers are ideally placed to provide advice at the lung cancer screening appointment. They could use this opportunity to offer patients personalised, visual feedback on the health of their lungs using their CT images, which patients may find motivating.

This feedback, combined with brief advice to increase patients’ belief that quitting will be of benefit and that they are able to quit (efficacy advice), could increase quit attempts following lung cancer screening.

However, radiographers need to feel confident delivering advice, and feel motivated to do so. It is therefore essential to develop training materials that engage and support the radiographers involved.

There has been little research on how radiographers view their potential role in health promotion, but a lack of knowledge and training have been identified as barriers. Exploring both radiographer and patient experiences of delivering and receiving the intervention will help to ensure the proposed intervention is acceptable and has real potential to be included in any future lung screening programme.

Expected findings and potential impact

We predict that involving radiographers and patients in the development of our training and intervention will ensure that the final package is acceptable.

We anticipate that radiographers will feel able and motivated to deliver this intervention and that patients who receive the intervention will value receiving personalised feedback that is easy to understand and delivered by a health professional.

We expect that radiographers will appreciate the training provided and the opportunity to develop their health promotion skills.

We will have an acceptable training and intervention package that we can take forward for testing in a larger study. The larger study will find out if our approach can help patients undergoing screening for lung cancer to stop smoking.

The proposed research will help to ensure smoking cessation advice is delivered in the most effective way, to maximise the potential patient benefit from lung cancer screening.

The development of specific training will equip radiographers to support patients, thereby improving the care offered to patients at screening. This could improve patient experiences of a lung cancer screening programme.

Ultimately, the proposed training and intervention could become a crucial component of a future UK lung cancer screening programme, and would help prevent lung cancer deaths.

Lead researchers: Dr Rebecca Beeken and Dr Nick Woznitza | Location: University of Leeds| Type of research: Patient experience