Four-part programme helps patients stop smoking before surgery

A simple four-part programme, including referral to a quit-smoking hotline and a free supply of nicotine patches, can increase the percentage of patients who quit smoking before undergoing surgery, reports a new study.

Smokers are at increased risk of complications after surgery, especially regarding breathing and poor wound healing.

The “easily implemented and inexpensive” programme significantly improves preoperative smoking cessation rates, according to the new research in Anesthesia & Analgesia by Dr Susan M Lee of University of Western Ontario and colleagues.

The study evaluated an intervention designed to promote smoking cessation in 168 smoking patients scheduled to undergo elective surgery. At clinic visits at least three weeks before their procedure, one group of patients received the study intervention, which consisted of:

  • Brief counselling (less than five minutes) by a nurse
  • Brochures on smoking cessation
  • Referral to a quit-smoking telephone hotline
  • A six-week supply of nicotine patches, provided free of charge

The other group received no specific quit-smoking intervention or advice. The two groups were compared for rates of smoking cessation at the time of surgery, confirmed by a breath test.

Most patients in both groups were still smoking when admitted to the hospital for surgery. However, the smoking cessation rate was higher for patients assigned to the quit-smoking intervention: about 14 percent, compared to four percent in the control group.

With adjustment for other factors, patients in the intervention group were four times more likely to stop smoking. Thirty days after surgery, patients assigned to the quit-smoking programme were still more likely to say they had stopped smoking: 29 versus 11 percent. However, smoking status at follow-up was not confirmed by testing.

The overall risk of complications before and after surgery was similar between groups: about 13 percent for patients assigned to the quit-smoking programme and 17 percent in the control group.

Dr Lee and colleagues conclude: “This intervention, and its straightforward implementation, dispel frequently raised objections to more active participation of anaesthetists in preoperative smoking cessation programmes.”

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