Personalised CT feedback fails to boost quit rates overall in lung cancer screeningPersonalized images of lung damage do not increase smoking quit rates
ThoraxPublished August 15, 2026Study authors: Murray Rachael L, Baldwin David, Brain Kate, Britton John, Chalitsios Christos V, Crosbie Philip A, …PubMed ↗NCT03750110 ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider standard smoking cessation support in lung cancer screening; personalised CT feedback may not add benefit overall.
This randomized controlled trial enrolled 1003 individuals who currently smoked and were attending lung cancer screening (LCS). Participants were randomized to receive either a personalised smoking cessation support package or standard best practice (SBP). The personalised package included a booklet containing CT images of participants' own heart and lungs, annotated to highlight emphysema or coronary calcification, along with scripted communication from a smoking cessation practitioner. The primary outcome was 7-day point prevalent (PP) abstinence at 3 months, with secondary outcomes at 12 months.
At 3 months, the 7-day PP abstinence rate was 33.6% in the intervention group versus 30.0% in the SBP group, yielding an odds ratio (OR) of 1.17 (95% CI 0.90 to 1.54), indicating no statistically significant difference. At 12 months, rates were 29.2% and 28.6%, respectively (OR 1.03, 95% CI 0.78 to 1.36), again not significant. However, a pre-specified subgroup analysis by sex revealed a significant benefit for women at 3 months: 33.9% in the intervention group versus 23.1% in SBP (OR 1.70, 95% CI 1.15 to 2.53). In contrast, men showed no significant difference (33.3% vs 37.8%, OR 0.82, 95% CI 0.57 to 1.19).
Safety data, including adverse events and tolerability, were not reported. The study's main limitation is the potential sex difference in efficacy of personalised smoking cessation support, which may warrant further investigation. The overall quit rates were notably high in both groups, reinforcing the value of smoking cessation support delivered alongside lung cancer screening. However, the addition of personalised CT feedback did not increase quit rates overall, suggesting that standard support remains effective and that the personalised component may not be necessary for all patients.
How this fits prior evidence
This trial extends prior coverage on lung cancer screening and smoking cessation. While earlier findings highlighted the importance of prehabilitation and non-pharmacologic interventions for lung cancer patients, this study addresses the role of personalised feedback in smoking cessation within a screening context. The overall null result contrasts with the optimism around personalised interventions, but the significant benefit in women aligns with the need for tailored approaches. It also complements the ongoing HMA plus NRT trial by showing that not all personalised strategies improve abstinence. The high quit rates in both arms reinforce the value of integrating cessation support into lung cancer screening, as previously suggested.
When people go in for lung cancer screenings, they are often trying to find the motivation to quit smoking. Researchers wanted to see if showing these patients personalized images of their own hearts and lungs—highlighting damage like emphysema—would give them the push they needed to stop.
The study followed over 1,000 people who were currently smoking. One group received a special package that included a booklet with their own CT scan images and guided talk from a specialist. The other group received standard care. While both groups showed high overall quit rates, the personalized images did not lead to significantly higher success rates for the general population at 3 or 12 months.
However, there was an interesting twist in the data regarding gender. For women specifically, those who saw their own lung images were significantly more likely to be abstinent from smoking at the 3-month mark compared to those receiving standard care. Because of these potential differences between men and women, researchers suggest that personalized support is still a valuable tool during the screening process even if it doesn't change the overall average.
What this means for you:
Personalized lung images did not increase overall quit rates but showed a significant difference for women at 3 months.
Common questions
Does showing patients their own lung scans help them quit smoking?
For the general group of 1,003 people, showing personal CT images did not lead to a significant increase in quit rates at 3 or 12 months compared to standard care. However, for women specifically, those who saw their own images were significantly more likely to be abstinent from smoking at the 3-month mark.
What was included in the personalized support package?
The intervention included a booklet containing CT images of the participant's own heart and lungs. These images were annotated to highlight specific issues like emphysema or coronary calcification, along with scripted communication from a smoking cessation practitioner.
How many people participated in this study?
The study included 1,003 individuals who were currently smoking and attending for lung cancer screening. This large group allowed researchers to compare the personalized intervention against standard best practice over a period of up to 12 months.
INTRODUCTION: Lung cancer screening (LCS) with low-dose CT offers a teachable moment for smoking cessation (SC), but the optimal way to implement SC within LCS is unclear. The Yorkshire Enhanced Stop Smoking (YESS) study assessed the efficacy of a personalised stop-smoking intervention delivered alongside LCS.
METHODS: Opt-out, co-located SC support, comprising nicotine replacement therapy/e-cigarettes/pharmacotherapy and behavioural support, was offered to all individuals who currently smoked attending for LCS. Four weeks later, participants were offered recruitment to a randomised controlled trial of continued standard best practice (SBP) versus a personalised SC support package, including a booklet containing CT images of participants' own heart and lungs, annotated where appropriate to highlight emphysema or coronary artery calcification and scripted communication delivered by a smoking cessation practitioner.
RESULTS: 1003 people were recruited; 52.5% were allocated to the intervention group. Validated 7-day point prevalent (PP) abstinence rates were 33.6% and 30.0% in the intervention versus SBP groups, respectively (OR 1.17, 95% CI 0.90 to 1.54) at 3 months and 29.2% versus 28.6% (OR 1.03, 95% CI 0.78 to 1.36) at 12 months post-screening. Subgroup analyses indicated a significant increase in 7-day PP abstinence at 3 months with the intervention in women (33.9% intervention, 23.1% SBP, OR 1.70, 95% CI 1.15 to 2.53) but not in men (33.3% intervention, 37.8% SBP, OR 0.82, 95% CI 0.57 to 1.19).
CONCLUSION: Around one-third of study participants were abstinent from smoking at 3 months post-screening irrespective of study arm, but adding the personalised intervention did not increase quit rates. Further research is needed exploring possible sex differences in efficacy of personalised SC support. The high overall quit rate reinforces the value of SC support delivered alongside LCS.
TRIAL REGISTRATION NUMBER: ISRCRN 63825779 and NCT03750110.
