ideasIdea
Every lung screening visit includes stop-smoking medicine, opt-out
Lung screening is a teachable moment. Giving cessation medicine and support by default at every scan, unless the person opts out, roughly doubles quit rates.
Opt-out cessation in screening programmes (e.g. the YESS trial) improves quit rates. Propose mandating opt-out pharmacotherapy (varenicline or cytisine) and counselling at every low-dose CT visit as a programme standard, with quit rate as a key performance indicator.
Hypothesis
Opt-out embedded cessation increases 12-month biochemically verified quit rates among screened smokers from about 10% to at least 20%.
Rationale
Cessation delivers more life-years than the scan itself in modelling, and the population is captive.
What would test it
Programme-level comparison plus an RCT of opt-out versus opt-in delivery.
Maturity
being tested at scale
Who has to act
clinic
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.