ArticlePreventive medicine reports2025
Missed opportunities for tobacco dependence treatment among U.S. veterans referred for lung Cancer screening: An observational cohort study.
Article in Preventive medicine reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
Abstract
Objective: Tobacco dependence treatment (TDT) should be offered to all lung cancer screening (LCS) participants who smoke. We sought to examine the provision of TDT among patients referred for LCS. Methods: We performed a multi-center, retrospective observational analysis of patients referred for LCS at seven regionally-affiliated Veterans Affairs Medical Centers and associated clinics from 9/2022-9/2023. We identified LCS referrals and tobacco use using administrative data. We extracted TDTs (±45 days from referral or Low-dose computed tomography [LDCT]) including medications and tobacco-related visits (TRVs). Outcomes included any pharmacotherapy, any TRV, and combined TDT (pharmacotherapy + two or more TRVs). Results were analyzed using generalized linear mixed effects models. Results: 9319 patients were referred for LCS, of whom 58.6 % currently smoked. Of those, 47.9 % resided in rural areas, 6.9 % were Black, 6.7 % were female; mean age was 67.7. Among those who currently smoked, 17.4 % received any pharmacotherapy, 13.6 % had at least one TRV, and 6.4 % had combined TDT. Participants in the LCS program were significantly more likely to receive medications around the time of the initial LDCT, with odds ratios (OR) < 1 for all comparison groups: interval scan OR 0.60 (95 %CI 0.48,0.76) no scan OR 0.65 (95 %CI 0.52,0.83), subsequent annual scan OR 0.59 (95 %CI 0.46,0.75). This pattern held for all three outcomes. Rural-residing individuals were less likely to have a TRV or receive combined TDT. Conclusions: We found low rates of TDT and a concerning drop off in treatment after initial LDCT. Failure to address tobacco throughout the longitudinal process represents a missed opportunity. Primary funding source:
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