The proposed study will test a medication plus text messaging intervention specifically designed for lung cancer screening patients. Half of the patients will receive standard of care, and half will receive the treatment intervention.

Screening for lung cancer at earlier, more treatable stages has the potential to reduce mortality from the U.S.'s most deadly cancer. Annual lung cancer screening with low-dose computed tomography is now recommended for high risk individuals based on age and smoking history. This study will evaluate a smoking cessation intervention for lung cancer screening patients. We will evaluate quit rates after a standard intervention (brief counseling session at time of lung cancer screening) versus a dual nicotine replacement therapy (NRT) and gain-framed text messaging intervention.

Inclusion:

1. 55 years or older
2. 30 pack year history of smoking
3. current smoker (defined as breath carbon monoxide>6ppm)
4. willing to be randomized
5. English speaking

Exclusion:

1. unstable psychiatric/medical conditions such as suicidal ideation, acute psychosis, severe alcohol dependence, substance abuse, or dementia
2. in the immediate (within 2 weeks) post myocardial infarction period
3. serious arrhythmias
4. unstable angina pectoris
5. hemodynamically or electrically unstable
6. currently taking part in any other tobacco treatment program or using cessation medication (i.e., taking NRT or other cessation medications, enrolled in the Quitline, in another drug study).

48 individuals were consented in to the study, but 7 withdrew before randomization and 1 withdrew after randomization. Those data are not included in baseline analyses.

Adverse events were monitored for the duration of the study (20 weeks)