Why was this work conducted?

Individuals aged 55-74 who currently or have previously smoked may be eligible for a lung health check by the NHS. These checks involve answering questions about lung health and smoking, and in some cases being offered a scan of the lungs. These checks can help diagnose lung cancer at an earlier stage leading to better outcomes. However, stopping smoking is still the best way to prevent lung cancer.

There is little research which looks at whether and how stop smoking support should be integrated into lung health checks. We received funding from Cancer Research UK to explore the attitudes and preferences about this from the perspective of people who are eligible to attend these checks.

What did we do?

We conducted interviews with thirty‐one individuals aged 55-80, who were eligible for lung cancer screening. These individuals either currently smoked or had recently quit. Interviews were carried out either using individual telephone interviews or focus groups. Data collected were analysed using thematic analysis.

What did we find?

Impact of lung screening on motivation to quit

First, participants felt that lung health checks are a good time to discuss stopping smoking, where in fact, hearing personal lung health information may increase motivation to stop. However, participants also mentioned that attendee’s motivation to quit may decrease if they do not need a lung scan or get a clear result. Therefore, staff should make sure to discuss the benefits of quitting regardless of result.    

Communication skills of lung health check staff

Participants said that they have been told many times in the past that they shouldn’t smoke and feel guilty about this. Therefore, participants felt staff need to think carefully about when and how to talk to attendees about quitting smoking and should be sensitive of their feelings. Asking about stopping smoking as soon as a lung health check starts, or asking multiple times was seen as intrusive and off-putting. Instead, participants recommended that support should be offered once. And if attendees say no, staff should accept this, and give details of organisations which can help them stop smoking, if they change their mind in the future. 

How support should be provided during the screening appointment

Participants felt that if attendees did wish to access support, they should be able to discuss options or receive samples of smoking cessation aids immediately. This could capitalise on the increased motivation they may have, and make sure referrals aren’t lost. They also viewed it as important that ongoing follow-up sessions are offered, and varied support options are available to suit individual preferences.

What next?

The results from this work will assist us in developing guidance to help lung health check services put these actions in place. Offering stop smoking support at this time may help people decide whether to quit smoking and can give a better chance of being successful.

Useful Links:

• Read the published journal article here (open access)
• Animation available here
• Information about lung health checks in England available here
• Information about NHS stop smoking services available here

About the Authors

Samantha Groves completed her BSc and MSc in Clinical and Health Psychology at the University of Manchester. Following this she worked as a research assistant between 2019-2021 with the Manchester Centre for Health Psychology on this project with Dr Lorna McWilliams.

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