Personalized Intervention Program: Tobacco Treatment for Patients at Risk for Lung Cancer (PIP)

The primary aims of this study are to test the efficacy two types of smoking cessation
methods (compared to standard care).

The aim of the first intervention is to evaluate the efficacy of a personalized message
intervention in improving tobacco quit rates above and beyond standard care smoking cessation
treatment in patients at risk for lung cancer. Messages will be designed specifically for
patients at risk for lung cancer, personalized and presented in a gain-framed manner, taking
into account demographics and smoking history.

The aim of the second intervention is to evaluate the efficacy of a novel, biofeedback-based
intervention that provides personalized individual-level feedback on biomarkers of lung
cancer risk and how they improve in response to cessation, delivered in a gain-framed way.
The biomarkers include skin carotenoid status, spirometry, and plasma bilirubin, all of which
improve with cessation. The study team will examine whether the biofeedback prevents relapse
in those who quit and leads to reductions in smoking in lung nodule patients who failed to
quit.

Additionally, this study will attempt to evaluate the impact of smoking cessation on miRNA
profiles in human serum, especially miRNAs in the let-7 family, which are known to have tumor
suppressor function, and which we hypothesize increase in response to cessation.

Inclusion Criteria:

- Current Smoker.

- 20 pack per year smoking history.

- Eligible for the Smilow treatment program.

- Willing to enroll in smoking cessation program.

- Willing to be randomized in smoking cessation study.

- English speaking.

Exclusion Criteria:

- Dementia or current serious psychiatric or unstable medical illness.

- Pregnancy or breast feeding.

- Known fat malabsorption diseases that may affect skin carotenoid status.