Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2015 Mar;120(3):582-587.
doi: 10.1213/ANE.0000000000000555.

Long-term quit rates after a perioperative smoking cessation randomized controlled trial

Susan M Lee  1 , Jennifer Landry, Philip M Jones, Ozzie Buhrmann, Patricia Morley-Forster
Affiliations
Randomized Controlled Trial

Long-term quit rates after a perioperative smoking cessation randomized controlled trial

Susan M Lee et al. Anesth Analg. 2015 Mar.

Abstract

Background: While surgery and perioperative smoking cessation interventions may motivate patients to quit smoking in the short term, it is unknown how often this translates into permanent cessation. In this study, we sought to determine the rates of long-term smoking cessation after a perioperative smoking cessation intervention and predictors of successful cessation at 1 year.

Methods: We previously reported short-term results from a perioperative randomized controlled trial comparing usual care with an intervention involving (1) brief counseling by the preadmission nurse, (2) smoking cessation brochures, (3) referral to a telephone quitline, and (4) a free 6-week supply of transdermal nicotine replacement. We now report our 1-year follow-up outcomes.

Results: Between October 2010 and April 2012, 168 patients were randomized. At 1 year, 127 patients (76%) were available for follow-up telephone interview. Smoking cessation occurred in 8% of control patients compared with 25% of patients in the intervention group (relative risk, 3.0; 95% confidence interval [CI], 1.2-7.8; P = 0.018). The number needed-to-treat to achieve smoking cessation for 1 patient at 1 year postoperatively was 5.9 (95% CI, 3.4-25.9). Multivariable logistic regression modeling found that the intervention (P = 0.020) and lower nicotine dependency at baseline (P < 0.001) were predictive of success at smoking cessation at 1 year. Poisson regression showed that adjusted for nicotine dependency, those randomized to the intervention group were 2.7 times (95% CI, 1.1-6.7; P = 0.028) more likely to achieve long-term cessation than those in the control group. Adjusted for randomization group, a low level of nicotine dependency resulted in a relative risk of quitting of 5.1 (95% CI, 2.0-12.8; P = 0.001).

Conclusions: This study demonstrates that an intervention designed for a busy preadmission clinic results in decreased smoking rates not only around the time of surgery but also continued benefit in smoking cessation at 1 year. Perioperative care providers have a unique opportunity to assist patients in smoking cessation and achieve long-lasting results.

Trial registration: ClinicalTrials.gov NCT01260233.

PubMed Disclaimer

Comment in

References

    1. Warner DO. Helping surgical patients quit smoking: why, when, and how. Anesth Analg. 2005;101:481–7
    1. Myles PS, Iacono GA, Hunt JO, Fletcher H, Morris J, McIlroy D, Fritschi L. Risk of respiratory complications and wound infection in patients undergoing ambulatory surgery: smokers versus nonsmokers. Anesthesiology. 2002;97:842–7
    1. Singh JA, Hawn M, Campagna EJ, Henderson WG, Richman J, Houston TK. Mediation of smoking-associated postoperative mortality by perioperative complications in veterans undergoing elective surgery: data from Veterans Affairs Surgical Quality Improvement Program (VASQIP)—a cohort study. BMJ Open. 2013;3:e002157
    1. Hawn M, Houston T, Campagna E, Graham L, Singh J, Bishop M, Henderson H. The attributable risk of smoking on surgical complications. Ann Surg. 2011;254:914–20
    1. Musallam KM, Rosendaal FR, Zaatari G, Soweid A, Hoballah JJ, Sfeir PM, Zeineldine S, Tamim HM, Richards T, Spahn DR, Lotta LA, Peyvandi F, Jamali FR. Smoking and the risk of mortality and vascular and respiratory events in patients undergoing major surgery. JAMA Surg. 2013;148:755–62

Publication types

MeSH terms

Associated data