期刊
JOURNAL OF GENERAL INTERNAL MEDICINE
卷 37, 期 11, 页码 2711-2718出版社
SPRINGER
DOI: 10.1007/s11606-022-07542-0
关键词
tobacco; preventative medicine; lung cancer screening
资金
- Health Resources and Services Administration [T32HP30037]
- Comparative Effectiveness Research Training in Primary Care program
- National Institutes of Health [UL1TR001860]
- Tobacco-Related Disease Research Program [28CP-0039]
- National Cancer Institute [P30CA093373-15S]
- University of California Davis Health System
Among former smokers eligible for lung cancer screening, one in five reported recent tobacco use and over half of those without recent tobacco use had recent tobacco exposure. Counseling and cotinine testing should be considered for former smokers eligible for lung cancer screening.
Background Lung cancer screening (LCS) for former and current smokers requires that current smokers are counseled on tobacco treatment. In the USA, over 4 million former smokers are estimated to be eligible for LCS based on self-report for not smoking now. Tobacco use and exposure can be measured with the biomarker cotinine, a nicotine metabolite reflecting recent exposure. Objective To examine predictors of tobacco use and exposure among self-reported former smokers eligible for LCS. Design Cross-sectional study using the 2013-2018 National Health and Nutrition Examination Survey. Participants Former smokers eligible for LCS (n = 472). Main Measures Recent tobacco use was defined as reported tobacco use in the past 5 days or a cotinine level above the race/ethnic cut points for tobacco use. Recent tobacco exposure was measured among former smokers without recent tobacco use and defined as having a cotinine level above 0.05 ng/mL. Key Results One in five former smokers eligible for LCS, totaling 1,416,485 adults, had recent tobacco use (21.4%, 95% confidence interval (CI) 15.8%, 27.0%), with about a third each using cigarettes, e-cigarettes, or other tobacco products. Among former smokers without recent tobacco use, over half (53.0%, 95% CI: 44.6%, 61.4%) had cotinine levels indicating recent tobacco exposure. Certain subgroups had higher percentages for tobacco use or exposure, especially those having quit within the past 3 years or living with a household smoker. Conclusions Former smokers eligible for LCS should be asked about recent tobacco use and exposure and considered for cotinine testing. Nearly 1.5 million former smokers eligible for LCS may be current tobacco users who have been missed for counseling. The high percentage of passive smokers is at least double that of the general nonsmoking population. Counseling about the harms of tobacco use and exposure and resources is needed.
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