Capitalizing on a teachable moment: Development of a targeted self-help smoking cessation intervention for patients receiving lung cancer screening

Lung Cancer. 2019 Apr;130:121-127. doi: 10.1016/j.lungcan.2019.02.014. Epub 2019 Feb 18.


Objective: The goal of the current study was to develop and examine the feasibility and acceptability of a self-help smoking cessation intervention targeted to the teachable moment of smokers undergoing low-dose computed tomography (LDCT) lung cancer screening.

Materials and methods: We used a multi-phase qualitative approach, including focus groups (N = 15) and learner verification interviews (N = 16) to develop a targeted intervention for patients receiving a LDCT screening, by extending and modifying a previously validated, self-help intervention. The new intervention was then tested in a feasibility study for acceptability and receptivity by smokers (N = 18) receiving a LDCT screening.

Results: The main themes that emerged from the focus group findings included a need to address the counterproductive thoughts regarding a negative lung screen result, the desire to enjoy a healthy and smoke-free retirement, the need to increase self-efficacy regarding smoking cessation, and the desire to see statistics regarding survival after quitting smoking. Learner verification findings showed that participants responded favorably to most booklet and pamphlet changes. Minor changes were made to improve comprehension and enhance self-efficacy. Formative findings led to the development of a new initial booklet titled, "Lung Cancer Screening & Quitting Smoking: Taking Control of Your Health," as well as modifications of the existing self-help cessation intervention. The intervention was designed to be initiated at the LDCT appointment, prior to receipt of scan results, and with minimal disruption of clinic work-flow. Results from the feasibility study indicated that acceptability and satisfaction with the new intervention were high.

Conclusion: A validated self-help smoking-cessation intervention was modified for smokers receiving LDCT screening for lung cancer based on formative research guided by the teachable moment concept. The new intervention is ready for testing in a randomized controlled trial.

Keywords: Lung cancer screening; Self-help intervention; Smoking cessation intervention; Teachable moment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cigarette Smoking / adverse effects*
  • Early Detection of Cancer
  • Feasibility Studies
  • Female
  • Focus Groups
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / prevention & control
  • Male
  • Middle Aged
  • Motivation
  • Patient Education as Topic
  • Reimbursement Mechanisms
  • Self Efficacy
  • Self-Help Groups*
  • Smokers
  • Smoking Cessation / methods*
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed