A 57-Year-Old Man Has Tried to Stop Smoking Unsuccessfully for the Past

A 57-year-old man has tried to stop smoking unsuccessfully for the past year. He has tried smoking cessation counseling and use of nicotine gum. Although he has no new symptoms, the „smokers cough" that he has had for years is a constant reminder that he is at risk of dying of lung cancer. He wants to know what measures he can take that have been shown to reduce that risk. In addition to a smoking cessation program, what is the best recommendation for this patient?

A) Daily dietary supplementation with the antioxidantl3-carotene
B) Daily isotretinoin, titrated to limit skin toxicity
C) Daily bupropion
D) An annual low-dose spiral CT scan of the chest
E) Sputum cytology every4 months