Interventions for preoperative smoking cessation effective

January 01, 0001

Interventions for preoperative smoking cessation effective

Clinical Question: How effective are preoperative interventions on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications?

Bottom line: Based on indirect comparisons and evidence from 2 small trials, interventions that begin 4 to 8 weeks before surgery and which include weekly counselling, and nicotine replacement therapy, are more likely than standard care to have an impact on complications and on long-term smoking cessation. None of the studies reported any adverse effects of preoperative smoking intervention.

Caveat: This review included 8 studies addressing smoking cessation but only 5 of them addressed postoperative complications. Six trials testing brief interventions increased smoking cessation at the time of surgery, but failed to detect a statistically significant effect on postoperative morbidity. The optimal preoperative intervention intensity remains unknown.

Context: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions.

Cochrane Systematic Review:Thomsen T et al. Interventions for preoperative smoking cessation. Cochrane Reviews, 2010, Issue 7. Article No. CD002294. DOI: 10.1002/14651858.CD002294.Pub3. This review contains 8 studies involving 1156 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 278, August 2010.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: Z. Social Problems. Keywords: smoking, cessation, interventions, preoperative
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 November 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.