Opportunity

Smoking remains the leading cause of preventable illness and death in the United States. Lung cancer screening reduces mortality among current and former smokers at high risk for lung cancer by increasing access to care and smoking cessation interventions. Patients who are Black, Hispanic, from rural residences, and/or have low socioeconomic status are at particular risk for poor smoking-associated health outcomes and may benefit preferentially from smoking cessation interventions delivered in conjunction with screening. However, which interventions are most effective at helping patients quit smoking is unknown.

Intervention

In the Healthy Lungs trial, researchers at Penn Medicine and three other health systems are leveraging Way to Health to compare smoking cessation interventions among more than 3,000 patients belonging to underserved groups who are referred for lung cancer screening.

Trial participants will be randomized into one of four arms that incrementally add interventions:

1. Basic usual care: ask-advise-refer (AAR) approach, in which clinicians ask questions, provide recommendations, and refer patients to resources;
2. Enhanced usual care: usual care plus free nicotine replacement therapy and reduced-cost FDA-approved pharmacotherapies;
3. Enhanced usual care plus financial incentives to stop smoking; and
4. Enhanced usual care plus financial incentives and a mobile health application that motivates patients to think about their future health by promoting episodic future thinking 

Impact 

The project has an expected completion date of April 2024. Results will be posted when they become available.