{
  "abstract": "Background The Quit Smoking Lung Health Intervention Trials (QuLIT-1 and -2), and other studies, show that providing immediate smoking cessation support within lung cancer screening services substantially improves quit rates. However, in the QuLIT2 trial, only around half of those offered smoking cessation support actually accepted it. Understanding what underpins this and how to facilitate higher engagement would enhance the health impact of the Targeted Lung Health Check programme.Method We compared characteristics of participants in the intervention arm of the QuLIT-2 study who accepted or declined the offer of smoking cessation support and conducted thematic analysis of interviews with 15 smokers who had declined it.Results Of 152 study participants randomised to smoking cessation support (61.3±4.8 years, 42% female), 80 declined the offer and 15 dropped out after the initial session, leaving 57 ‘accepters’. Accepters were more likely to be female (53% vs 40% adjusted OR (AOR): 3.30, 95% CI 1.47 to 7.48), younger (AOR: 0.90 (0.80 to 0.98)) and were more likely to live in areas of medium or low deprivation (AOR: 5.30 (1.86 to 22.85)). Thematic analysis of the interviews revealed four main barriers to acceptance: (1) mental health as a barrier, (2) personal beliefs about quitting smoking, (3) perceived usefulness of the interventions offered and (4) past negative experiences of smoking cessation support.Discussion Cessation services embedded in lung screening programmes need to anticipate barriers such as mental health concerns, past unsuccessful quit attempts experiences and personal beliefs. Efforts should be made to design and offer equitable services that meet the needs of this population.Trial registration number ISRCTN12455871.",
  "authors": [
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "Parris J Williams"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "Sara C Buttery"
    },
    {
      "affiliations": [
        "Imperial College London National Heart and Lung Institute, London, UK"
      ],
      "name": "Alexis Perkins"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "Keir Elmslie James Philip"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK",
        "Royal Brompton and Harefield Hospitals, London, UK"
      ],
      "name": "Ley T Chan"
    },
    {
      "affiliations": [
        "RM Partners, London, London, UK"
      ],
      "name": "Jane Derbyshire"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "Emily C Bartlett"
    },
    {
      "affiliations": [
        "Department of Radiology, Royal Brompton Hospital, London, UK"
      ],
      "name": "Anand Devaraj"
    },
    {
      "affiliations": [
        "NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK"
      ],
      "name": "Michael I Polkey"
    },
    {
      "affiliations": [
        "Department of Primary Care and Public Health, Imperial College, London, UK"
      ],
      "name": "Anthony A Laverty"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "Nicholas S Hopkinson"
    }
  ],
  "title": "Exploring the predictors and barriers to accepting smoking cessation support within a targeted lung health check setting",
  "uid": "4bb1dc92-e701-538d-9274-5ab143975347"
}