Patients receiving a brief intervention to help them quit smoking before elective surgery are still more likely to be nonsmokers at 1-year follow-up, according to a study in Anesthesia & Analgesia.
In fact, the simple, inexpensive program triples the percentage of patients with long-term smoking cessation at 1 year after surgery.
In a follow-up study of 168 patients from a previous randomized trial, one group of patients received the smoking-cessation program while patients in the control group received usual care.
The four-part program consisted of brief counseling (less than 5 minutes) by a nurse, brochures on smoking cessation, referral to a quit-smoking hotline, and a free 6-week supply of nicotine patches.
About 14% of patients in the intervention group were confirmed as quitting smoking before surgery, compared to just 4% of the control group, the original study showed.
In the new study, researchers performed follow-up interviews with 127 of the patients. One year after surgery, 25% of patients in the intervention group said that they were no longer smoking, compared to 8% in the comparison group. (The patient reports were not confirmed by testing in the follow-up study.)
Patients in the intervention group were three times more likely to be nonsmokers at 1 year on adjusted analysis. For every six patients enrolled in the program, one additional patient had achieved long-term smoking cessation, the study showed. The effect remained significant even assuming that all patients lost to follow-up continued to smoke.
For every six patients enrolled in the program, one additional patient had achieved long-term smoking cessation, the study showed. The effect remained significant even assuming that all patients lost to follow-up continued to smoke.
Patients with lower scores for nicotine dependence were six times more likely to be successful long-term quitters. None of 22 patients with chronic obstructive pulmonary disease were able to achieve long-term cessation—although this wasn’t a statistically significant predictor. Smoking history in “pack years” also didn’t predict 1-year smoking status.
Anesthesiologists commonly evaluate patients before surgery, providing a chance to inform smokers about their excess risk, and to encourage them to stop smoking before their operation. “Undergoing surgery can serve as a ‘teachable moment’ that may motivate patients to engage in permanent smoking cessation,” report the researchers led by Susan M. Lee, MD, who was at the University of Western Ontario, London, Canada, at the time of the study. Lee is now at University of California, San Francisco.