Abstract
BACKGROUND: To plan cessation services and advance health equity, understanding factors related to cessation readiness and differences among patients presenting for lung cancer screening (LCS) is imperative. METHODS: We recruited smoking patients, ages 55 to 77 years, presenting for LCS in 26 community-based imaging clinics participating in an NCI Community Oncology Research Program site-randomized trial (WF-20817CD, UG1CA189824). We collected outcomes of smoking cessation readiness to change and quitting self-efficacy immediately prior to screening. Linear mixed models were constructed with site random effects to assess associations of outcomes and baseline characteristics. RESULTS: Participants (N = 1,094; age = 63.7; 81.9% White, 13.3% Black, 2.6% Hispanic, 2.3% American Indian, 20.2% nonmetro) were even by gender (50.8% women) and educational attainment (51.1% ≤ high school education). Participants smoked an average of 17.2 cigarettes per day (SD = 9.6), with a mean pack-year of 46.1 (SD = 25.0). Predictors of increased cessation readiness included the following: being a man, increased worry about lung cancer, increased perceived benefits of quitting, a quit attempt within the past year, and smoking ≤10 cigarettes per day. Predictors of increased quitting self-efficacy included the following: non-White race/ethnicity, men, less education, no use of other tobacco products, increased perceived benefits of quitting, a quit attempt within the past year, and smoking ≤10 cigarettes per day. CONCLUSIONS: To support cessation among patients undergoing LCS, imaging clinics and health systems should recognize that prescreening readiness to quit varies by population subgroups. Imaging clinics may benefit from a tailored approach that works with patients "where they are." IMPACT: These findings suggest that gender, race, and ethnicity are associated with smoking cessation readiness and quitting self-efficacy.