Studies Examining the Importance of Smoking After Being Diagnosed With Lung Cancer

• Median and 2-year survival rates in confirmed smokers versus non- smokers newly diagnosed with lung cancer. [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  

• Median survival and 2-year survival rates by smoking status for early (Stage I/II NSCLC) versus those with advanced (Stage III/IV) NSCLC. [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  
• Number of treatment complications in smokers versus non-smokers (frequency surgical wound complications, radiotherapy induced pneumonitis and median total radiation (Gy) dose; frequency and duration of neutropenic sepses [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  
• Point prevalence of smoking at 0, 3, 6 12, 24 months [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  
• Comparison of changes in health related quality of life (EQ5D) in smokers versus non-smokers [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  
• Accrual and attendance rates of lung cancer patients attending a hospital smoking cessation service [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  
• Estimate of cost per quality adjusted life year gained by smoking cessation advice in both quit strategies for smokers [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  

Smoking causes around 85% of lung cancer. Continued smoking after diagnosis probably worsens survival and increases treatment complications but prospective well-designed studies are lacking.

This project consists of two simultaneous studies:

1. An observational cohort study recording outcomes in smokers, never-smokers, and ex-smokers, using exhaled carbon monoxide to validate smoking status when they attend for further lung cancer clinics.
2. A pilot controlled trial (RCT) where proven (eCO>10 ppm or self reported) smokers receiving a diagnosis of lung cancer will be randomised to receive either standardized physician-initiated advice to stop smoking or a referral to our specialist hospital-based smoking cessation service.

This project is unique, as every patient with a clinical diagnosis of lung cancer will have their smoking status biologically validated by a quick and easy test, and those enrolled in the smoking cessation trial will also complete a generic quality of life questionnaire at regular intervals. These appointments will coincide with other hospital appointments wherever possible, and survival status will reported up to 24 months after enrolment.