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Co-development of an evidence-based personalised smoking cessation intervention for use in a lung cancer screening context

Quinn-Scoggins, Harriet D.; Murray, Rachael L.; Quaife, Samantha L.; Smith, Pamela; Brain, Kate E.; Callister, Matthew E. J.; Baldwin, David R.; Britton, John; Crosbie, Philip A. J.; Thorley, Rebecca; McCutchan, Grace M.

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Harriet D. Quinn-Scoggins

Samantha L. Quaife

Pamela Smith

Kate E. Brain

Matthew E. J. Callister

David R. Baldwin

John Britton

Philip A. J. Crosbie

Grace M. McCutchan


Background: Optimising smoking cessation services within a low radiation-dose computed tomography (LDCT) lung cancer screening programme has the potential to improve cost-effectiveness and overall efficacy of the programme. However, evidence on the optimal design and integration of cessation services is limited. We co-developed a personalised cessation and relapse prevention intervention incorporating medical imaging collected during lung cancer screening. The intervention is designed to initiate and support quit attempts among smokers attending screening as part of the Yorkshire Enhanced Stop Smoking study (YESS: ISRCTN63825779). Patients and public were involved in the development of an intervention designed to meet the needs of the target population. Methods: An iterative co-development approach was used. Eight members of the public with a history of smoking completed an online survey to inform the visual presentation of risk information in subsequent focus groups for acceptability testing. Three focus groups (n = 13) were conducted in deprived areas of Yorkshire and South Wales with members of the public who were current smokers or recent quitters (within the last year). Exemplar images of the heart and lungs acquired by LDCT, absolute and relative lung cancer risk, and lung age were shown. Data were analysed thematically, and discussed in stakeholder workshops. Draft versions of the intervention were developed, underpinned by the Extended Parallel Processing Model to increase self-efficacy and response-efficacy. The intervention was further refined in a second stakeholder workshop with a patient panel. Results: Individual LDCT scan images of the lungs and heart, in conjunction with artistic impressions to facilitate interpretation, were considered by public participants to be most impactful in prompting cessation. Public participants thought it important to have a trained practitioner guiding them through the intervention and emphasising the short-term benefits of quitting. Presentation of absolute and relative risk of lung cancer and lung age were considered highly demotivating due to reinforcement of fatalistic beliefs. Conclusion: An acceptable personalised intervention booklet utilising LDCT scan images has been developed for delivery by a trained smoking cessation practitioner. Our findings highlight the benefit of co-development during intervention development and the need for further evaluation of effectiveness.


Quinn-Scoggins, H. D., Murray, R. L., Quaife, S. L., Smith, P., Brain, K. E., Callister, M. E. J., …McCutchan, G. M. (2022). Co-development of an evidence-based personalised smoking cessation intervention for use in a lung cancer screening context. BMC Pulmonary Medicine, 22(1), Article 478.

Journal Article Type Article
Acceptance Date Nov 24, 2022
Online Publication Date Dec 15, 2022
Publication Date Dec 15, 2022
Deposit Date Jan 18, 2023
Publicly Available Date Jan 18, 2023
Journal BMC Pulmonary Medicine
Electronic ISSN 1471-2466
Peer Reviewed Peer Reviewed
Volume 22
Issue 1
Article Number 478
Keywords Research, Lung cancer, Lung cancer screening, Emphysema, Smoking cessation, Intervention, Imaging/CT MRI, Patient and public involvement, Co-development
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