Promoting Smoking Cessation in Lung Cancer Screening Through Proactive Treatment

This trial is a pragmatic randomized trial targeting the care of current smokers who are
participating in lung cancer screening at two VA sites. Primary care providers at these sites
will be randomized, and half will be offered tools to help integrate proactive smoking
cessation support into the lung cancer screening process. Key proactive elements include
proactive telephone outreach to all current smokers by a VA Quitline counselor that follows
mailed results letters, and providing providers guidance in offering proactive cessation
medication support as part of the lung cancer screening process.

Inclusion Criteria:

- Providers who schedule patients for a lung cancer screening at either of the two VA
sites.

- Patients who participate in lung cancer screening and are current smokers at the time
of scheduling their screening exam.

Exclusion Criteria:

- Providers who currently systematically prescribe cessation support medication to all
current smokers will be excluded.

- Patients with urgent findings requiring biopsy/immediate attention on the screening CT
will be excluded.

- Patients with a prior diagnosis of lung cancer or who are receiving active therapy for
any cancer, except skin cancer, will be excluded.

- Patients previously diagnosed with cognitive impairment, dementia, or severe
behavioral disorders, or have an indication in chart review of difficulty
communicating or participating in telephone counseling sessions will be excluded.