{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:14:52Z","timestamp":1789398892241,"version":"build-2803163510"},"reference-count":52,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n National-level data are limited on the long-term costs and outcomes of integrating smoking cessation interventions into lung cancer screening (LCS) programs in the US.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the cost-effectiveness of smoking cessation interventions in LCS using data from 4 randomized clinical trials implemented within the National Cancer Institute\u2019s Smoking Cessation at Lung Examination (SCALE) Collaboration.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n In this economic evaluation, data were pooled from individuals enrolled across 23 arms in 4 SCALE trials from October 2016 to April 2023. Included participants were eligible for LCS and currently smoked. Data were analyzed from May 2025 to June 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n LCS with and without cessation interventions. The 23 arms were classified into 8 composite treatment classes based on low, moderate, and high intensities of pharmacotherapy and counseling.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n From a societal perspective, cost per quit was estimated during trial follow-up periods and incremental cost-effectiveness ratios over a lifetime horizon. Intervention costs were micro-costed at steady state. Trial data were extended to a lifetime horizon using an established lung cancer microsimulation model. Costs and quality-adjusted life-years (QALYs) were discounted at 3%. Sensitivity analyses tested the estimated effects of varying quit rates, costs, background cessation rates, relapse, and screening uptake and adherence.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 2520 participants (mean [SD] age, 63.8 [5.8] years), 1278 (50.7%) were male. Mean (range) treatment class costs varied from $38.96 ($2.43-$57.45) to $803.10 ($563.18-$1212.73) per participant, with self-reported quit rates ranging from a mean (range) of 10.1% (8.0%-13.0%) to 27.3% (19.5%-31.4%). The lowest-intensity treatment class had the lowest cost per quit at $329.85, whereas the highest-intensity treatment class had the highest at $2945.35. Model projections suggested that the high-intensity pharmacotherapy and low-intensity counseling treatment class yielded the lowest lifetime costs ($1.54 billion per 100\u202f000 screen-eligible population) and the second-highest QALYs (2.26 billion years per 100\u202f000 screen-eligible population). The highest-intensity treatment class achieved the highest QALYs, at an incremental cost-effectiveness ratio of $991.15 per QALY. Compared with screening alone, joint cessation and screening programs were cost-saving. Results were robust across sensitivity analysis scenarios.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this economic evaluation of integrating smoking cessation interventions in LCS, joint cessation and screening programs were associated with substantial health benefits and favorable cost-effectiveness. These findings may be useful for health systems to guide decisions, while considering budget and capacity, on the modality and intensity of cessation interventions to adopt.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.33630","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:01:17Z","timestamp":1789398077000},"page":"e2633630","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness of Smoking Cessation Interventions Integrated Into Lung Cancer Screening"],"prefix":"10.1001","volume":"9","author":[{"given":"Pianpian","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Public Health, Purdue University, West Lafayette, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laney","family":"Smith","sequence":"additional","affiliation":[{"name":"Whiddon College of Medicine at the University of South Alabama, 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