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BACKGROUND Annual lung cancer screening with low-dose computed tomography is recommended for adults aged 55-80 with a ≥30 pack-year smoking history that currently smoke or quit less then 15-years ago. The 50% who are current smokers should be offered cessation interventions, but information about the impact of adding cessation to screening is limited. METHODS We used an established lung cancer simulation model to compare the effects on mortality of a hypothetical one-time cessation intervention and annual screening vs. annual screening