***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Smoking  cessation treatment is now integrated into many health-care systems and a major research effort is under way to improve current success rates . Until now results from r and omized clinical trials have been reported in many different ways , leading to problems of interpretation . We propose six st and ard criteria comprising the ' Russell St and ard ' ( RS ) . These criteria are applicable to trials of cessation aids where participants have a defined target quit date and there is face-to-face contact with research ers or clinic staff , as follows . ( 1 ) Follow-up for 6 months ( RS6 ) or 12 months ( RS12 ) from the target quit date or the end of a predefined ' grace period ' ; ( 2 ) self-report of smoking abstinence over the whole follow-up period allowing up to five cigarettes in total ; ( 3 ) biochemical verification of abstinence at least at the 6-month or 12-month follow-up point ; ( 4 ) use of an ' intention-to-treat ' approach in which data from all r and omized smokers are included in the analysis unless they have died or moved to an untraceable address ( participants who are included in the analysis are counted as smokers if their smoking status at the final follow-up can not be determined ) ; ( 5 ) following-up ' protocol violators ' and using their true smoking status in the analysis ; and ( 6 ) collecting follow-up data blind to smokers ' allocation to trial group . We believe that these criteria provide the best compromise between practicability and surrogacy for long-term cessation and will enable meaningful comparison between studies . There may be good reasons why other outcome criteria would also be reported , and studies that involve interventions with special groups or where there is no design ated target quit date or face to face contact would need to adapt these criteria accordingly Background : The effect of low-dose CT screening for lung cancer on smoking habits has not been reported in large r and omised controlled trials . Methods : This study evaluated the effect on smoking habits of screening with low-dose CT at 1-year follow up in the Danish Lung Cancer Screening Trial ( DLCST ) , a 5-year r and omised controlled trial comprising 4104 subjects ; 2052 subjects received annual low-dose CT scan ( CT group ) and 2052 received no intervention ( control group ) . Participants were healthy current and former smokers ( > 4 weeks since smoking cessation ) with a tobacco consumption of > 20 pack years .  Smoking habits were determined at baseline and at annual screening . Smoking status was verified using exhaled carbon monoxide levels . Lung function tests , nicotine dependency and motivation to quit smoking were assessed . Quit rates and relapse rates were determined at 1-year follow-up for all subjects . Results : At 1 year the quit rates among smokers were 11.9 % in the CT group and 11.8 % in the control group ( p = 0.95 ) . Relapse rates for former smokers were 10.0 % and 10.5 % in the CT and control groups , respectively ( p = 0.81 ) . Significant predictors ( p<0.05 ) for smoking cessation were : high motivation to quit , low dependency , low ratio of forced expiratory volume in 1 s to forced vital capacity , low pack years , higher age , longer period of abstinence and CT findings necessitating 3-month repeat CT scans . Conclusions : Overall , quit rates were similar in the CT and control group at 1-year follow-up , with a net quit rate of 6.0 % . Quit rates were higher and relapse rate lower among subjects with initial CT findings that necessitated a repeat scan 3 months later BACKGROUND The aggressive and heterogeneous nature of lung cancer has thwarted efforts to reduce mortality from this cancer through the use of screening . The advent of low-dose helical computed tomography ( CT ) altered the l and scape of lung-cancer screening , with studies indicating that low-dose CT detects many tumors at early stages . The National Lung Screening Trial ( NLST ) was conducted to determine whether screening with low-dose CT could reduce mortality from lung cancer . METHODS From August 2002 through April 2004 , we enrolled 53,454 persons at high risk for lung cancer at 33 U.S. medical centers . Participants were r and omly assigned to undergo three annual screenings with either low-dose CT ( 26,722 participants ) or single-view posteroanterior chest radiography ( 26,732 ) . Data were collected on cases of lung cancer and deaths from lung cancer that occurred through December 31 , 2009 . RESULTS The rate of adherence to screening was more than 90 % . The rate of positive screening tests was 24.2 % with low-dose CT and 6.9 % with radiography over all three rounds . A total of 96.4 % of the positive screening results in the low-dose CT group and 94.5 % in the radiography group were false positive results . The incidence of lung cancer was 645 cases per 100,000 person-years ( 1060 cancers ) in the low-dose CT group , as compared with 572 cases per 100,000 person-years ( 941 cancers ) in the radiography group ( rate ratio , 1.13 ; 95 % confidence interval [ CI ] , 1.03 to 1.23 ) . There were 247 deaths from lung cancer per 100,000 person-years in the low-dose CT group and 309 deaths per 100,000 person-years in the radiography group , representing a relative reduction in mortality from lung cancer with low-dose CT screening of 20.0 % ( 95 % CI , 6.8 to 26.7 ; P=0.004 ) . The rate of death from any cause was reduced in the low-dose CT group , as compared with the radiography group , by 6.7 % ( 95 % CI , 1.2 to 13.6 ; P=0.02 ) . CONCLUSIONS Screening with the use of low-dose CT reduces mortality from lung cancer . ( Funded by the National Cancer Institute ; National Lung Screening Trial Clinical Trials.gov number , NCT00047385 . ) Objective To evaluate the impact of telling patients their estimated spirometric lung age as an incentive to quit smoking . Design R and omised controlled trial . Setting Five general practice s in Hertfordshire , Engl and . Participants 561 current smokers aged over 35 . Intervention All participants were offered spirometric assessment of lung function . Participants in intervention group received their results in terms of  “  lung age ” ( the age of the average healthy individual who would perform similar to them on spirometry ) . Those in the control group received a raw figure for forced expiratory volume at one second ( FEV1 ) . Both groups were advised to quit and offered referral to local NHS smoking cessation services . Main outcome measures The primary outcome measure was verified cessation of smoking by salivary cotinine testing 12 months after recruitment . Secondary outcomes were reported changes in daily consumption of cigarettes and identification of new diagnoses of chronic obstructive lung disease . Results Follow-up was 89 % . Independently verified quit rates at 12 months in the intervention and control groups , respectively , were 13.6 % and 6.4 % ( difference 7.2 % , P=0.005 , 95 % confidence interval 2.2 % to 12.1 % ; number needed to treat 14 ) . People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group . Cost per successful quitter was estimated at £ 280 ( € 366 , $ 556 ) . A new diagnosis of obstructive lung disease was made in 17 % in the intervention group and 14 % in the control group ; a total of 16 % ( 89/561 ) of participants . Conclusion Telling smokers their lung age significantly improves the likelihood of them quitting smoking , but the mechanism by which this intervention achieves its effect is unclear . Trial registration National Research Register N0096173751 The purpose of this study was to examine the effectiveness of different practice -based approaches to assist patients of primary care physicians to quit smoking and sustain cessation .  Forty-four nonsmoking general practitioners volunteered for the study . After a period of training , they r and omized 923 smoking clients , unselected for motivation toward quitting , to four different intervention groups : ( i ) minimal intervention , consisting of one single counselling session and a brief h and out on quitting techniques ; ( ii ) repeated counselling including reinforcing sessions at Months 1 , 3 , 6 , and 9 ; ( iii ) repeated counselling and use of nicotine gum ; and ( iv ) repeated counselling and spirometry . Biochemically vali date d smoking status was assessed at six and 12 months after recruitment . The proportion of verified quitters at 12 months was 4.8 percent among subjects r and omized to the minimal intervention group , compared to 5.5 percent , 7.5 percent , and 6.5 percent among those r and omized to the three repeated-counselling groups . In no treatment group was the outcome significantly different from that for one-time counselling at the ( P<0.05 ) level . Lack of power , contamination , and low attendance at reinforcing sessions should be taken into account in interpreting the results Introduction : A r and omized trial has demonstrated that lung cancer screening reduces mortality . Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level . Methods : Six U.S. cohorts ( men and women aged 50 , 60 , or 70 years ) were simulated in an existing patient-level lung cancer model . Smoking histories reflected observed U.S. patterns . We simulated lifetime histories of 500,000 identical individuals per cohort in each scenario . Costs per quality -adjusted life-year gained ( $ /QALY ) were estimated for each program : computed tomography screening ; st and -alone smoking cessation therapies ( 4–30 % 1-year abstinence ) ; and combined programs . Results : Annual screening of current and former smokers aged 50 to 74 years  costs between $ 126,000 and $ 169,000/QALY ( minimum 20 pack-years of smoking ) or $ 110,000 and $ 166,000/QALY ( 40 pack-year minimum ) , when compared with no screening and assuming background quit rates . Screening was beneficial but had a higher cost per QALY when the model included radiation-induced lung cancers . If screen participation doubled background quit rates , the cost of annual screening ( at age 50 years , 20 pack-year minimum ) was below $ 75,000/QALY . If screen participation halved background quit rates , benefits from screening were nearly erased . If screening had no effect on quit rates , annual screening  costs more but provided fewer QALYs than annual cessation therapies . Annual combined screening/cessation therapy programs at age 50 years costs $ 130,500 to $ 159,700/QALY , when compared with annual st and -alone cessation . Conclusions : The cost-effectiveness of computed tomography screening will likely be strongly linked to achievable smoking cessation rates . Trials and further modeling should explore the consequences of relationships between smoking behaviors and screen participation Background Lung cancer screening may provide a new opportunity for attempts to quit among smokers or might delay smoking cessation , but studies to date failed to provide evidence for this . This study investigated the effect of lung cancer screening on smoking abstinence in male smokers participating in the Dutch – Belgian r and omised controlled lung cancer screening trial ( NELSON trial ) . Methods In the NELSON trial , 50- to 75-year-old participants at high risk for developing lung cancer were r and omised to either lung cancer screening or no screening .  Smoking behaviour was evaluated in two r and om sample s of male smokers in the screen ( n=641 ) and  control arm ( n=643 ) before ( T0 ) and 2 years after r and omisation ( T1 ) . In addition , the data were also analysed by intention-to-treat ( ITT ) analysis , as recommended in smoking cessation intervention trials , although non-response in screening trials can also be due to reasons other than continued smoking . Results Almost 17 % ( 16.6 % ) of the trial participants quit smoking , which is higher than the 3–7 % found in the general adult population . However , screening was associated with a lower prolonged abstinence rate ( 14.5 % ) compared with no screening ( 19.1 % ) ( OR 1.40 , 95 % CI 1.01 to 1.92 ; p<0.05 ) . No stastistically significant difference was found after performing an ITT analysis . Conclusions This study showed that all trial participants were inclined to stop smoking more than average , which suggests that screening is a teachable moment to improve smoking behaviour . In those who underwent screening  the smoking abstinence rate was significantly lower than for the control group , although the difference was modest . After ITT analysis this difference was no longer observed . Clinical trial number IS RCT N63545820 Lung cancer screening with computed tomography has demonstrated a significant reduction in mortality . While these findings are important for the lung cancer research field , the most important risk factor for lung cancer , i.e. smoking , should not be ignored . We performed a pilot study to examine the feasibility of delivering a program that included both tobacco dependence treatment and lung cancer screening . The objectives of this study were to : ( 1 ) estimate the proportion of smokers who complied with a 12-week treatment protocol that included both tobacco dependence treatment and lung cancer screening 
    Output:
    
The process of LDCT lung cancer screening did not influence smoking behaviors .
LDCT recipients with results concerning for lung cancer had higher abstinence rates than those with scans without such findings .
This association may have a dose-response relationship in terms of the number of abnormal CT scans as well as the seriousness of the finding .
Limited evidence suggests LDCT lung cancer screening itself does not influence smoking behaviors , but positive results are associated with increased abstinence .