Clearing the Air: Empowering High-risk Adults with Digital Tools for Smoking Cessation and Lung Canc

Cooley ME, Kim SS, Xiong N, Heiling H, Mazzola E, Nayak MM, DeMarco R, Borondy-Kitts A, Underhill M, Healey MJ, Yang CJ, Lathan C, Castaldi PJ.
Clearing the Air: Empowering High-risk Adults with Digital Tools for Smoking Cessation and Lung Cancer Screening Adoption
Lung Cancer. 2025 Jul 1;206:108647. doi: 10.1016/j.lungcan.2025.108647. Epub ahead of print. PMID: 40669310.

Background: Even though lung cancer screening decreases mortality, uptake remain low. Research has focused on integrating smoking cessation into lung cancer screening programs rather than providing lung cancer screening education to eligible adults. Engaging individuals who are at high-risk for lung cancer and educating them about lung cancer screening is a critical next step. This study tested efficacy of a digital intervention to improve smoking cessation and lung cancer screening adoption.

Methods: Participants (n = 152) were enrolled into a randomized controlled trial of a digital intervention (counseling, nicotine replacement treatment, storytelling videos, and lung cancer screening decision-aide) versus a brief intervention (brief advice for smoking cessation, referral to the Quitline and mailing lung cancer screening decision-aide). Demographic, tobacco, and lung health data were collected electronically. Salivary cotinine test verified 7-day point-prevalence abstinence (PPA) rates were obtained at 3 and 6-months after study entry. Descriptive statistics, Fisher's exact test, Wilcoxon rank-sum test and logistic regression were used for analyses.

Results: As compared to the brief arm, the digital intervention had higher rates of biochemically verified 7-day PPA at 3 (35.1 % vs. 15.4 %, p = 0.006) and 6-months (24.3 % vs.10.3 %, p = 0.03). Participants in the digital arm had higher rates of lung cancer screening adoption at 6-months after study entry (58.1 % vs. 29.5 %, p < 0.001).

Conclusions: The digital intervention increased smoking cessation and uptake of lung cancer screening adoption compared to a brief intervention. Testing of the digital intervention among a diverse population is warranted to promote earlier detection and decreased mortality from lung cancer.