Exploring the predictors and barriers to accepting smoking cessation support within a targeted lung health check setting
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background The Quit Smoking Lung Health Intervention Trials (QuLIT-1 and -2), and other studies, show that providing immediate smoking cessation support within lung cancer screening services substantially improves quit rates. However, in the QuLIT2 trial, only around half of those offered smoking cessation support actually accepted it. Understanding what underpins this and how to facilitate higher engagement would enhance the health impact of the Targeted Lung Health Check programme.
Method We compared characteristics of participants in the intervention arm of the QuLIT-2 study who accepted or declined the offer of smoking cessation support and conducted thematic analysis of interviews with 15 smokers who had declined it.
Results Of 152 study participants randomised to smoking cessation support (61.3±4.8 years, 42% female), 80 declined the offer and 15 dropped out after the initial session, leaving 57 ‘accepters’. Accepters were more likely to be female (53% vs 40% adjusted OR (AOR): 3.30, 95% CI 1.47 to 7.48), younger (AOR: 0.90 (0.80 to 0.98)) and were more likely to live in areas of medium or low deprivation (AOR: 5.30 (1.86 to 22.85)). Thematic analysis of the interviews revealed four main barriers to acceptance: (1) mental health as a barrier, (2) personal beliefs about quitting smoking, (3) perceived usefulness of the interventions offered and (4) past negative experiences of smoking cessation support.
Discussion Cessation services embedded in lung screening programmes need to anticipate barriers such as mental health concerns, past unsuccessful quit attempts experiences and personal beliefs. Efforts should be made to design and offer equitable services that meet the needs of this population.
Trial registration number ISRCTN12455871.
Method We compared characteristics of participants in the intervention arm of the QuLIT-2 study who accepted or declined the offer of smoking cessation support and conducted thematic analysis of interviews with 15 smokers who had declined it.
Results Of 152 study participants randomised to smoking cessation support (61.3±4.8 years, 42% female), 80 declined the offer and 15 dropped out after the initial session, leaving 57 ‘accepters’. Accepters were more likely to be female (53% vs 40% adjusted OR (AOR): 3.30, 95% CI 1.47 to 7.48), younger (AOR: 0.90 (0.80 to 0.98)) and were more likely to live in areas of medium or low deprivation (AOR: 5.30 (1.86 to 22.85)). Thematic analysis of the interviews revealed four main barriers to acceptance: (1) mental health as a barrier, (2) personal beliefs about quitting smoking, (3) perceived usefulness of the interventions offered and (4) past negative experiences of smoking cessation support.
Discussion Cessation services embedded in lung screening programmes need to anticipate barriers such as mental health concerns, past unsuccessful quit attempts experiences and personal beliefs. Efforts should be made to design and offer equitable services that meet the needs of this population.
Trial registration number ISRCTN12455871.
Date Issued
2025-12-17
Date Acceptance
2025-11-23
Citation
BMJ Open Respiratory Research, 2025, 12 (1)
ISSN
2052-4439
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open Respiratory Research
Volume
12
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
License URL
Identifier
10.1136/bmjresp-2024-002713
Publication Status
Published
Article Number
ARTN e002713