‘Every touch point is an opportunity’: tobacco control experts' views on how to implement smoking cessation interventions within an Australian lung cancer screening program

Background: Targeted lung cancer screening (LCS) presents unique opportunities for smoking cessation among high-risk individuals. Implementation requires consideration of context-specific determinants. We sought perspectives from tobacco control/smoking cessation experts on optimally implementing smoking cessation interventions in an Australian LCS program. Methods: Recruitment was via maximum variation and snowball sampling in 2022. Individual/pair interviews explored factors that may influence acceptability and feasibility, potential delivery models, and implementation strategies. We interpreted interview data using codebook thematic analysis, then mapped key topics against the Consolidated Framework for Implementation Research and previous LCS expert-identified determinants. Results: Expert participants' (N = 30) roles included program/policy managers, researchers and clinicians, working in academia, not-for-profits/peak bodies and health departments. They emphasised the benefits of integrating smoking cessation interventions into routine LCS encounters. Key barriers included perceived professional and LCS participant reluctance, stigma, and rural access. Experts discouraged duplicating current cessation resources, and suggested prioritising implementation efforts. Flexible delivery models, addressing needs of priority populations (e.g., rural/remote, culturally and linguistically diverse), were recommended. Experts generally favoured a ‘hybrid’ intervention pathway, combining internal and external cessation services, to maximise feasibility and uptake. Training program staff on cessation intervention delivery and leadership buy-in were emphasised as essential requirements. Discussion: In this Australian tobacco control expert sample, there was near-unanimous support for embedding cessation interventions within routine LCS delivery and capitalising on opportunities to overcome current service delivery barriers. In conjunction with LCS participant perspectives, findings are relevant to planning and implementing cessation interventions in LCS contexts.