Problems and Alternatives for Korea National Lung Cancer Screening Program for Smoking Cessation: Analysis of a Survey Involving Experts

Background: Since 2019, the National Lung Cancer Screening Program, which targets high-risk smokers, has made smoking cessation counseling mandatory during result consultations in Korea.To implement smoking cessation counseling, we surveyed experts to investigate the status, issues, and improvement measures of smoking cessation counseling.Methods: We designed a survey to assess the status of smoking cessation counseling (including whether it is conducted during lung cancer screening result consultations, methods used, frequency of prescribing smoking cessation medications, among others) and improvement measures (from the perspectives of examinees, counseling physicians, clinic managers, and government officials).In December 2023, we sought cooperation from the top 100 institutions with high screening implementation rates and received responses from 35 individuals, including counseling physicians and smoking cessation specialists.We allowed for multiple responses and described the frequency for each survey separately.Results: Of smokers, 71.4% received smoking cessation counseling, primarily within 3 minutes on the result consultation day (61.1%).Only 36.1% of smokers were registered for same-day support programs and medication prescriptions.Only 13.9% of smokers were frequently prescribed cessation medications, with 30.6% having never been prescribed cessation medication.Improvement suggestions included showing lung cancer screening results (55.6% by examinees), reimbursement for medications (58.3% by physicians and government), and increasing counseling sessions (63.9% by clinic management).Conclusion: Even among proactive experts in lung cancer screening and smoking cessation counseling, frequency of actual prescription of cessation medications was low.Experts suggested alternatives such as increasing reimbursement, coverage for smoking cessation medications and treatment, and separate pricing for counseling.