Previous observations suggest that patients with positive findings on screening (as in, suspicious lung nodules) were more likely to quit smoking compared to patients who have negative findings. However, in my own clinical experience, when my patients either decline or obtain the screening, I am surprised how little the testing changes attitudes and behaviors about smoking cessation. I am also puzzled by how many patients decline the screening because they are not ready to quit smoking.
Recently published data by Golden et al. [Golden SE, et al. Prev Med Rep. 2022 Oct 5;30:102014. PMCID: PMC9551209.] has helped me to understand the thought process from a patient perspective. In this study, investigators performed interviews among patients who currently, or formerly, smoked who experienced cancer screening decision-making discussions.
The majority of smokers reported that lung cancer screening had no influence on their motivation to quit smoking with all of them reporting that the results had little impact on this motivation. All patients agreed that clinicians, like myself, should incorporate discussions about smoking in every clinical encounter. I was pleased to discover that most patients do not feel that negative screening (as in, no cancer or suspicious findings) gave them “license to smoke.”
I have learned that lung cancer screening is not a teachable moment. However, I change the conversation and encourage all my patients to get the screening “whether they want to quit or not.” In addition, I encourage all smokers to ask their providers whether lung cancer screening is right for them knowing that likely it will not influence the decision to quit.
Again, and most importantly, let’s not let readiness to quit be a barrier for obtaining this potentially life-saving screening.
Dr. Ebbert
Medical Director
Photo by Robina Weermeijer
