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
. 2021 Jul 1;35(7):345-351.
doi: 10.1097/BOT.0000000000002028.

Prospective Randomized Trial on Smoking Cessation in Orthopaedic Trauma Patients: Results From the Let's STOP (Smoking in Trauma Orthopaedic Patients) Now Trial

Paul E Matuszewski  1 , Katherine Joseph  2 , Nathan N O'Hara  3 , Carlo DiClemente  4 , Robert V O'Toole  3
Affiliations
Randomized Controlled Trial

Prospective Randomized Trial on Smoking Cessation in Orthopaedic Trauma Patients: Results From the Let's STOP (Smoking in Trauma Orthopaedic Patients) Now Trial

Paul E Matuszewski et al. J Orthop Trauma. .

Abstract

Objectives: Determine if extended inpatient counseling increases smoking cessation.

Design: Prospective randomized trial.

Setting: Level I trauma center.

Patients/participants: Current smokers with an operative fracture.

Intervention: Randomly assigned to control (no counseling), brief counseling (inpatient counseling), or extended counseling (brief counseling plus follow-up counseling) groups in a 1:3:3 ratio.

Main outcome measurements: Smoking cessation confirmed by exhaled carbon monoxide at 3 and 6 months. Secondary outcomes are proportion accepting services from a nationally based quitline.

Results: Overall, 266 patients participated, with 40, 111, and 115 patients in the control and 2 treatment groups, respectively. At 3 months, 17% of control patients versus 11% in the brief counseling and 10% in the extended counseling groups quit smoking, respectively (P = 0.45, 0.37). At 6 months, 15% of control, and 10% and 5% of the respective counseling groups quit (P = 0.45, 0.10). Extended counseling patients were 3 times more likely to accept referral to a quitline [odds ratio (OR), 3.1; 95% confidence interval (CI), 1.4-6.9], and brief counseling patients were more than 2 times as likely to accept referral (OR, 2.3; 95% CI, 1.0-5.1) than the control group. Extended counseling (OR, 8.2; 95% CI, 1.0-68.5) and brief counseling (OR, 5.3; 95% CI, 0.6-44.9) patients were more likely to use quitline services than the control group.

Conclusion: Increasing levels of inpatient counseling can improve successful referral to a smoking quitline, but it does not seem to influence quit rates among orthopaedic trauma patients. Extended counseling does not appear to provide substantial benefit over brief counseling.

Level of evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

PubMed Disclaimer

Conflict of interest statement

R. V. O'Toole is a paid consultant for CoorsTek, Imagen, and Smith & Nephew, receives stock options from Imagen, and receives royalties from CoorsTek, unrelated to this study. The remaining authors report no conflict of interest.

References

    1. MacKenzie EJ, Bosse MJ, Kellam JF, et al. Characterization of patients with high-energy lower extremity trauma. J Orthop Trauma. 2000;14:455–466.
    1. McCrabb S, Baker AL, Attia J, et al. Smoking, quitting, and the provision of smoking cessation support: a survey of orthopaedic trauma patients. J Orthop Trauma. 2017;31:e255–e262.
    1. Neptune D, Bonevski B, Enninghorst N, et al. The prevalence of smoking and interest in quitting among surgical patients with acute extremity fractures. Drug Alcohol Rev. 2014;33:548–554.
    1. Castillo RC, Bosse MJ, MacKenzie EJ, et al. Impact of smoking on fracture healing and risk of complications in limb-threatening open tibia fractures. J Orthop Trauma. 2005;19:151–157.
    1. Scolaro JA, Schenker ML, Yannascoli S, et al. Cigarette smoking increases complications following fracture: a systematic review. J Bone Joint Surg Am. 2014;96:674–681.

Publication types