Article

Interventions in the preoperative clinic for long term smoking cessation: a quantitative systematic review

Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
Canadian Journal of Anaesthesia (Impact Factor: 2.5). 06/2008; 55(1):11-21. DOI: 10.1007/BF03017592
Source: PubMed

ABSTRACT To assess the efficacy of interventions offered to patients in the preoperative clinic to promote long-term (> or = three months) smoking cessation following surgery.
We searched The Cochrane Library, MEDLINE, EMBASE and CINAHL for all randomized controlled trials (RCTs) on smoking-cessation interventions initiated in the preoperative clinic. Trial inclusion, quality assessment, and data extraction were performed independently by two authors. Standard meta-analytic techniques were applied.
Four RCTs (n = 610 patients) were included in the review. Interventions included pharmacotherapy, counseling, educational literature and postoperative telephone follow-up. The follow-up period ranged between three to 12 months with only one RCT following up patients for > one year. Two studies used biochemical methods to validate subjects' self-reporting of smoking cessation at the follow-up assessment. Overall, the interventions were associated with a significantly higher cessation rate vs control at the three to six month follow-up period (pooled odds ratio: 1.58, 95% confidence interval (CI) 1.02-2.45, P value = 0.01, I(2) = 0%). The only trial with longer follow-up period (12 months), however, failed to show any significant difference between the intervention and control groups (odds ratio: 1.05, 95% CI 0.53-2.09, P value = 0.88).
This systematic review suggests that smoking-cessation interventions initiated at the preoperative clinic can increase the odds of abstinence by up to 60% within a three- to six-month follow-up period. To evaluate the possibility of longer abstinence, future trials with at least one-year follow-up are recommended.

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Available from: Frances Chung, Aug 15, 2014
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    • "Finally, the selection based on full text resulted in a total number of 23 systematic reviews: 14 on smoking cessation (Windsor et al., 1998; Revere and Dunbar, 2001; van der Meer et al., 2001; Blenkinsopp et al., 2003; Lumley et al., 2004; Sinclair et al., 2004; Lancaster and Stead, 2005; Rice and Stead, 2006; Rigotti et al., 2007; Barth et al., 2008; Naughton et al., 2008; Rice and Stead, 2008; Stead et al., 2008; Zaki et al., 2008) 6 on exercise promotion (Eakin et al., 2000; Pinto et al., 2000; Lawlor and Hanratty, 2001; Eden et al., 2002; Levack et al., 2006; Hudon et al., 2008), 2 on healthy diets (Thompson et al., 2003; Nield et al., 2008) and 1 on both exercise and diets (Wilcox et al., 2001; Thompson et al., 2003; Nield et al., 2008). "
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