Smoking cessation services and shared decision-making practices among lung cancer screening facilities: A cross-sectional study

Lisa M. Lowenstein, Shawn P.E. Nishi, Maria A. Lopez-Olivo, Laura Covarrubias Crocker, Noah Choi, Bumyang Kim, Ya Chen “Tina” Shih, Robert J. Volk

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Little is known about how screening facilities are meeting the requirements for the reimbursement of lung cancer screening from the Centers for Medicare & Medicaid Services (CMS), including 1) the collection and submission of data to the CMS-approved registry (American College of Radiology [ACR] Lung Cancer Screening Registry), 2) the verification of a counseling and shared decision-making (SDM) visit having occurred as part of the written order for lung cancer screening with low-dose computed tomography, and 3) the offering of smoking cessation interventions. Methods: The authors identified facilities in a southwestern state that were listed by either the ACR Lung Cancer Screening Registry or the GO2 Foundation Centers of Excellence. To select facilities, they used 2 purposive sampling approaches: maximum variation sampling and snowball sampling. They surveyed facilities from February to November 2019. Results: There were 87 facilities contacted, and a total of 63 facilities representing 32 counties across Texas completed the survey. Nearly all facilities used Lung-RADS to classify nodules (92%; n = 58) and submitted data to a CMS-approved registry (92%; n = 57). Most facilities verified that the counseling and SDM visit had occurred (86%; n = 54). Although slightly more than half of the facilities reported always providing self-help cessation materials (68%; n = 42), similar or higher proportions of facilities reported that they never referred smokers to onsite cessation services (68%; n = 42) or quitlines (77%; n = 47), provided cessation counseling (81%; n = 50), or recommended medications (85%; n = 52). Conclusions: In general, screening facilities are meeting CMS requirements for screening, but they are struggling to offer smoking cessation interventions other than providing self-help materials.

Original languageEnglish (US)
Pages (from-to)1967-1975
Number of pages9
Issue number10
StatePublished - May 15 2022


  • early detection
  • health care delivery
  • lung neoplasms
  • shared decision-making
  • smoking cessation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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