Pre-op program fosters long-term smoking cessation

An extinguished cigarette is pictured in an ashtray in a bar in downtown Zurich September 28, 2008.

NEW YORK (Reuters Health) - Smokers who are scheduled for surgery and attend a smoking cessation program before their procedure have a good chance of being tobacco-free a year later, new research shows.

The results, which appear in the medical journal Anaesthesia, also indicate that the quit-smoking program reduced rates of postop complications.

For the study, 117 surgery patients were assigned either to participate in the program, starting 4 weeks before surgery and continuing for 4 weeks afterward, or to a usual-care "control" group.

"The intervention group attended weekly meetings or received telephone support and were provided with free nicotine replacement therapy, while the control group just received standard pre-operative care," Dr. Omid Sadr Azodi explained in a statement.

One interesting finding, according Sadr Azodi, who is with the Karolinska Institute in Stockholm, was the high study refusal rate. Many patients, he noted, simply refused to take part in the study because they did not want to give up smoking or were stressed by their upcoming operation.

Throughout the period around their surgery, 36 percent of patients in the program completely refrained from smoking compared with just 2 percent of control patients

A year later, the abstinence rate in the intervention group was more than double that of the control group: 33 percent vs. 15 percent. A low level of nicotine dependence increased the odds of 1-year smoking abstinence.

"Our intervention was for a fairly intense 8-week period, but we recognize that people with higher levels of dependency may need longer to help them stop smoking before surgery," Sadr Azodi noted.

SOURCE: Anaesthesia, March 2009.