A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants

Elyse R. Park, Joanna M. Streck, Ilana F. Gareen, Jamie S. Ostroff, Kelly A. Hyland, Nancy A. Rigotti, Hannah Pajolek, Mark Nichter

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Introduction: The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers' risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. Methods: A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1-2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. Results: Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants' heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. Conclusions: Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence.

Original languageEnglish (US)
Pages (from-to)166-173
Number of pages8
JournalNicotine and Tobacco Research
Volume16
Issue number2
DOIs
StatePublished - 2014

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Lung Neoplasms
Smoking
Lung
Smoking Cessation
Radiology
Cues
Cognitive Dissonance
Aptitude
Risk-Taking
Counseling
Emotions
Guidelines
Interviews
Health
Neoplasms

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

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A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants. / Park, Elyse R.; Streck, Joanna M.; Gareen, Ilana F.; Ostroff, Jamie S.; Hyland, Kelly A.; Rigotti, Nancy A.; Pajolek, Hannah; Nichter, Mark.

In: Nicotine and Tobacco Research, Vol. 16, No. 2, 2014, p. 166-173.

Research output: Contribution to journalArticle

Park, Elyse R. ; Streck, Joanna M. ; Gareen, Ilana F. ; Ostroff, Jamie S. ; Hyland, Kelly A. ; Rigotti, Nancy A. ; Pajolek, Hannah ; Nichter, Mark. / A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants. In: Nicotine and Tobacco Research. 2014 ; Vol. 16, No. 2. pp. 166-173.
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