Hanne Tonnesen

• MD, PhD, Specialist of Surgery
• Head of Research Professor and Director of WHO-CC at Lund University

Background/Objective: Smoking is an individual risk factor for bladder cancer. Many patients are still smoking at the time of their diagnosis, yet few trials have examined smoking cessation interventions (SCIs) in relation to transurethral resection of the bladder tumor (TURBT). This study therefore aimed to compare the efficacy of a hospital-based...

The implementation of nature-based interventions has demonstrated a positive impact on health outcomes and overall wellbeing. The knowledge of nature-based smoking cessation interventions is sparse but might offer potential benefits for smokers undertaking an intensive smoking cessation program. This study assessed the feasibility in real life of t...

Background The use of stereotactic body radiotherapy (SBRT) to definitively treat oligometastases in prostate cancer has drawn large clinical and research interests within radiation oncology. However, the evidence is considered in its early stages and there is currently no systematic review of randomized controlled trials (RCTs) in this field. We a...

Bladder cancer is the tenth most common cancer worldwide, with non-muscle invasive bladder cancer (NMIBC) accounting for 75% of cases. Transurethral resection of bladder tumours (TURBT) is the standard treatment, but it is associated with significant risks of complications and recurrence. Risky lifestyle factors, including smoking, malnutrition, ob...

Background Post-intervention follow-up is challenging in research and practice. In tobacco reports, patients with missing follow-up were considered smokers. Based on patient and staff preferences, an add-on intensified follow-up procedure after intensive tobacco and nicotine cessation interventions was developed. This study examined the impact of t...

Rehabilitation programs for patients diagnosed with Type 2 diabetes mellitus (T2DM) include smoking cessation to reduce development of complications and pre-mortality. This study aimed to compare successful smoking cessation after the intensive 6-week Gold Standard Program (GSP) among smokers with and without T2DM in Denmark. Additionally, we evalu...

In this study, the effect of the intensive “Quitter” intervention for smoking cessation was examined and compared to the standardized intensive intervention used in Denmark. The Quitter intervention, based on the Gold Standard Program (Q-GSP), involves large groups of approximately 70 participants, while the standardized GSP typically involves grou...

Background The disruption of health and medical education by the COVID-19 pandemic made educators question the effect of online setting on students’ learning, motivation, self-efficacy and preference. In light of the health care staff shortage online scalable education seemed relevant. Reviews on the effect of online medical education called for hi...

Background: Lung cancer, once rare, has evolved into the global leading cause of cancer-related mortality, primarily driven by widespread cigarette smoking in the 20th century. This study explores the historical trends of lung cancer incidence in Denmark over four decades, emphasizing the impact of smoking prevalence, age, and gender on the observe...

Background This study aimed to compare the effect on postoperative complications of prehabilitation targeting predefined co-existing risky lifestyle factors with usual preoperative routines in surgical patients. Methods This systematic review followed the PRISMA 2020 guideline and the protocol (CRD42022282611). Five databases were searched from inc...

Background: The postoperative complication rate is 30–64% among patients undergoing muscle-invasive and recurrent high-risk non-muscle-invasive bladder cancer surgery. Preoperative risky alcohol use increases the risk. The aim was to evaluate the accuracy of markers for identifying preoperative risky alcohol. Methods: Diagnostic test sub-study of a...

Background Rheumatoid arthritis (RA) is a chronic, inflammatory rheumatic disease with the potential to induce significant disability. Patients with RA are at increased risk of cardiovascular diseases (CVD). Smokers with RA tend to experience more pain and fatigue, higher disease activity, more erosive joint destruction, and a lower health-related...

Achieving high follow-up rates after smoking cessation interventions (SCIs) is a general challenge. The aim of this study was to identify preferences among patients and therapists for improving follow-up rates and to assess smoking status at 6 months among patients lost to follow-up. From the Danish STOPbase for Tobacco and Nicotine, which collects...

Background: Research indicates that among the risks associated with young people's alcohol and illicit drug use are sexual risks. However, insights into co-occurrence of substance use and sexual risks in adolescent samples and possible differences across countries are limited. Methods: A sample of 1449 adolescents from Belgium, Sweden, the Czech Re...

Purpose Daily smoking or risky drinking increases the risk of complications after surgery by ~50%. Intensive prehabilitation aimed at complete cessation reduces the complication rate but is time-consuming. The purpose of this study was to carry out preoperative pilot tests (randomized design) of the feasibility (1A) and validation (1B) of two novel...

Background: Smoking cessation treatment is an important prognostic factor for survival after a cancer diagnosis, especially for tobacco-related cancers. After being diagnosed with lung cancer, approximately 50% of patients continue smoking or frequently relapse after a quit attempt. Given the importance of smoking cessation treatment for cancer su...

This article contributes guidance on how to approach the development of a course curriculum in general and presents a specific example from medical research education. The purpose of this study is to discuss a model for translating needs assessments of targeted learners into a course curriculum. The model employs established methods for data collec...

Hvordan får vi fat på flere deltagere, når vi følger op på effekten af forløb, hvor deltagere kvitter tobak og nikotin? Det er omdrejningspunktet for STOPbasens temarapport baseret på interviews med både rådgivere og deltagere omkring opfølgning 6 måneder efter et kursusforløb.

I rapporten kan du læse om effekten af stopforløb for unge op til 35 år i perioden 2017-2021 med opfølgning i 2022. Det er meget opmuntrende, at effekten af stopforløb blandt de unge rygere er på linje med landsgennemsnittet.

Objectives To evaluate the efficacy of intensive smoking cessation interventions (ISCIs) directly compared with shorter interventions (SIs), measured as successful quitting. Method Medline, Embase, the Cochrane Library and CINAHL were searched on 15 October 2021. Peer-reviewed randomised controlled trials (RCTs) of adult, daily smokers undergoing...

Objectives Insufficient sleep is a public health problem that impacts the mental and physical health of children and adolescents. Complaints of insomnia are particularly pervasive among adolescents. This longitudinal study investigates factors that contribute to teen insomnia symptoms. Design Five-year prospective follow-up study. Setting School-...

Background The Minimal Insomnia Symptom Scale (MISS) is a three-item screening instrument that has been found to be psychometrically sound and capable of screening for insomnia among adults and older people. This study aimed to test the measurement properties of the MISS together with an additional item focusing on daytime functioning among adolesc...

(1) Background: Smoking cessation may be very difficult, even if smoking aggravates the prognosis of a disease, which has been shown to be the case for persons with rheumatoid arthritis (RA). In contrast, an association in patients with osteoarthritis (OA) is still disputed. The primary objective was to compare smokers diagnosed with RA and OA to c...

Background There is a large unused potential for risk reduction in the preoperative period via effective lifestyle intervention targeting co-existing risky lifestyles: Smoking, malNutrition, obesity, risky Alcohol intake and insufficient Physical activity (SNAP). This trial compares the efficacy of the integrated STRONG programme with standard care...

Background and purpose: High alcohol intake is associated with increased risk of postoperative complications. Alcohol cessation intervention is recommended prior to elective surgery. We investigated short- and long-term effects of perioperative intensive alcohol intervention in relation to acute ankle fracture surgery. Patients and methods: 70 p...

Background Evidence concerning the reduction of postoperative complications due to smoking and alcohol drinking in patients undergoing radical cystectomy is incomplete. Objective To evaluate the efficacy of a 6-wk smoking and/or alcohol cessation intervention, initiated shortly before surgery and continued until 4 wk after, in reducing complicatio...

Introduction Tobacco is still one of the single most important risk factors among the lifestyle habits that cause morbidity and mortality in humans. Furthermore, tobacco has a heavy social gradient, as the consequences are even worse among disadvantaged and vulnerable groups. To reduce tobacco-related inequity in health, those most in need should b...

Although scientific publication is often mandatory in medical professions, writing the first research article for publication is challenging, especially as medical curricula have only a minor focus on scientific writing. The aim was therefore to identify facilitators and barriers experienced by medical doctors writing their first scientific article...

Debat: https://lakartidningen.se/opinion/debatt/2021/07/svensk-rokavvanjning-kan-forbattras/

Background In Scandinavia, people with a severe mental disorder have a reduced life expectancy of 15–20 years compared with the general public. Smoking is a major contributor, and smoke-free policies are increasingly adopted in psychiatric clinics around the world. We compared potential facilitators and barriers among staff and management, for the...

Introduction: Patients addicted to alcohol or drug often have additional unhealthy lifestyles, adding to the high mortality and morbidity in this patient group. Therefore, it is important to consider lifestyle interventions as part of the usual addiction treatment. Objective: The aim was to identify predictors of successful changes in lifestyle...

Objective Cigarette smoking and alcohol drinking are preventable risk factors in surgery. It is unknown whether intervening on these two risk factors also have an effect on other lifestyles. Therefore, the primary aim of this study was to compare the effect of an intensive alcohol and smoking cessation intervention on other lifestyles (malnutrition...

Background Implementation in healthcare is often slow and poorly reported. Results include suboptimal outcomes and adverse consequences for patients. However, promising tools to remedy implementation speed and reporting already exist – such as the evidence-based, fast-track implementation model (Fast-IM) and the comprehensive RE-AIM (reach, effecti...

Purpose: Insomnia affects up to one in four adolescents and has been shown to have a negative impact on their mental and physical health. This study aimed to investigate the association between insomnia, academic performance, self-reported health, physical activity, school start time, and substance use among adolescents. Methods: A survey with a...

Objectives: Risky alcohol use before surgery is associated with an increased risk of postoperative complications and longer hospital stays. Preoperative alcohol interventions can improve surgical outcomes but are not commonly integrated into routine care. This study sought to better understand patient's and provider's perceptions of alcohol-relate...

Background Compared to the general population, patients with alcohol and drug addiction have an increased risk of additional hazardous lifestyles and suffer from more chronic diseases, adding to their already significantly higher morbidity and mortality. The objective of this study was to test the efficacy of the Very Integrated Program (VIP) on tr...

Background Sleep deprivation among adolescents is a major public health issue. Although previous studies have described their sleep habits and the consequences thereof, the voices of adolescents themselves are rarely heard. The aim of this study was to investigate adolescents’ experiences regarding what they perceived as facilitators and barriers f...

Objective: To investigate the influence of intravenous (iv) fluid volumes on the secretion of N-terminal-pro-brain natriuretic peptide (NT-Pro-BNP) in colorectal surgical patients and its association with cardiopulmonary complications (CPC). In addition, to examine if preoperative NT-Pro-BNP can predict the risk for postoperative CPC. Methods: B...

Smokers are at increased risk for surgical complications. Despite the known benefits of smoking cessation, many perioperative health care providers do not routinely provide smoking cessation interventions. The variation in delivery of perioperative smoking cessation interventions may be due to limited high-level evidence for whether smoking cessati...

Meeting adherence is an important element of compliance in treatment programmes. It is influenced by several factors one being self-efficacy. We aimed to investigate the association between self-efficacy and meeting adherence and other factors of importance for adherence among patients with alcohol and drug addiction who were undergoing an intensiv...

Abstract Background Implementation of clinical health promotion (CHP) aiming at better health gain is slow despite its effect. CHP focuses on potentially modifiable lifestyle risks such as smoking, alcohol, diet, and physical inactivity. An operational program was created to improve implementation. It included patients, staff, and the organization,...

Rygestopbasen præsenterer her effekten og omfanget af rygestopbehandling i Danmark for året 2017 med opfølgning i løbet af 2018. Rygestopbasen er national, gratis og åben for alle indsatser, der tilbyder rygestopbehandling. Alle deltagere i Rygestopbasen har givet informeret samtykke til registrering af deres data. Rygestopbasen er godkendt af Vide...

Background Most patients with alcohol and drug addiction have other risky lifestyles and non-communicable diseases (NCDs), adding to their morbidity and pre-mortality. Those are, however, potentially preventable. The aim was to identify and compare the patients in treatment for alcohol and drug addiction and identify important factors for high risk...

Background: Risky consumption of alcohol is a global problem. More than 3.3 million deaths annually are associated with risky use of alcohol, and global alcohol consumption continues to increase. People who have high alcohol consumption often require planned and emergency surgical procedures.Risky drinking is associated with increased postoperativ...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the efficacy and safety of disulfiram in the treatment of patients with alcohol use disorders on short-term and long-term outcomes compared to other pharmacological treatment, placebo or no treatment.

Objectives Health promotion is on the global agenda. The risks targeted include smoking, hazardous alcohol consumption, nutrition and insufficient physical activity. Implementation of clinical health promotion, however, remains a major challenge. While several processes, models and frameworks for strategic implementation exist, very few have been t...

Interview_Guide – Supplemental material for Staff experiences with strategic implementation of clinical health promotion: A nested qualitative study in the WHO-HPH Recognition Process RCT

Objectives We compared the effectiveness of an intensive smoking cessation intervention among smokers with and without a severe mental disorder (SMD) and identified factors associated with successful quitting. The main hypothesis was that smokers with an SMD would be less likely to stay continuously smoke-free for 6 months. Design A prospective co...

Background Rheumatoid arthritis (RA) is a chronic, inflammatory rheumatic disease with the potential to induce significant disability. Patients with RA are at increased risk of cardiovascular diseases (CVD). Smokers with RA tend to experience more pain and fatigue, higher disease activity, more erosive joint destruction and a lower health-related q...

Rygestopbasen præsenterer her effekten og omfanget af rygestopbehandling i Danmark for året 2016 med opfølgning i løbet af 2017. Rygestopbasen er national, gratis og åben for alle indsatser, der tilbyder rygestopbehandling. Alle deltagere i Rygestopbasen har givet informeret samtykke til registrering af deres data. Rygestopbasen er godkendt af Vid...

Background Despite smoking and risky alcohol drinking being modifiable risk factors for cancer as well as postoperative complications, perioperative cessation counselling is often ignored. Little is known about how cancer patients experience smoking and alcohol interventions in relation to surgery. Therefore the aim of this study was to explore how...

Background Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insu...

Surgical quality registries: large room for improvement if they should be used for analyses of life style risk factors and the effect of preoperative initiatives on postoperative complications Tobacco, alcohol, malnutrition, overweight and physical inactivity increase postoperative morbidity. Preoperative intervention has been shown to improve the...

Background Radical cystectomy is associated with high rates of perioperative morbidity. Robotic-assisted radical cystectomy (RARC) is widely used today despite limited evidence for clinical superiority. The aim of this review was to evaluate the effect of RARC compared to open radical cystectomy (ORC) on complications and secondary on length of sta...

Background To evaluate the effect of a smoking-, alcohol- or combined-cessation intervention starting shortly before surgery and lasting 6 weeks on overall complications after radical cystectomy. Secondary objectives are to examine the effect on types and grades of complications, smoking cessation and alcohol cessation, length of hospital stay, hea...

Objectives: We compared the effectiveness of the Gold Standard Programme (a comprehensive smoking cessation intervention commonly used in Denmark) with other face-to-face smoking cessation programmes in Denmark after implementation in real life, and we identified factors associated with successful quitting. Design Prospective cohort study. Settin...

Background: The Danish Smoking Cessation Database (SCDB) was established in 2001 as the first national healthcare register within the field of health promotion. Aim of the database: The aim of the SCDB is to document and evaluate smoking cessation (SC) interventions to assess and improve their quality. The database was also designed to function as...

On December 14 and 15, 2016, an international multidisciplenary panel met in Copenhagen for an international workshop on the process towards the Tobacco Endgame.

Background Clinical health promotion comprises services delivered in health care to address daily smoking, risky alcohol use, overweight/obesity, malnutrition and physical inactivity. Clinical health promotion significantly improves treatment results and patient safety. Accordingly, it is a core component of overall quality in hospitals. To further...

Background: Mid-to-late adolescence is a critical period for initiation of alcohol and drug problems, which can be reduced by targeted brief motivational interventions. Web-based brief interventions have advantages in terms of acceptability and accessibility and have shown significant reductions of substance use among college students. However, th...

Complex regional pain syndrome (CRPS) is a complex, painful, debilitating disease which occurs after trauma or surgery mainly in the wrists with a variation of 5.5-26.2 at 100,000 inhabitants in international studies. In Denmark the prevalence is unknown, and it is perceived that many patients with CRPS are diagnosed late in their illness. There is...

Background: In many countries, smoking is considered as the most important preventable risk factor for a complicated pregnancy and delivery. However in Denmark, there is no clear picture of pregnant women. The aim was therefore to examine the prevalence, characteristics and registration of maternal smoking and quitting during pregnancy as well as e...

Aims: In this article we explore the moderators of effectiveness ofWISEteens (Web-based brief Intervention for SubstancE using teens), a fully automated web-based brief motivational intervention targeting risky substance use among adolescents. Based on previous studies, we examined the differential effects on drinking of sex, readiness to change, s...

Background Patients with acute and chronic pain have a significantly reduced quality of life, and it is a clinical impression that unhealthy lifestyle influences the experience of pain. To evaluate this, surgery can be seen as a controlled trauma and acute pain model with standardised guidelines. The aim was to investigate the association between l...

Background In many countries, smoking is considered as the most important preventable risk factor for a complicated pregnancy and delivery. However in Denmark, there is no clear picture of pregnant women. The aim was therefore to examine the prevalence, characteristics and registration of maternal smoking and quitting during pregnancy as well as es...

Abstract Background: The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery. Methods: A single-blinded randomized clinical trial conducted at two vascular surgery departments in Denmark. The intervention group...

The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery. A single-blinded randomized clinical trial conducted at two vascular surgery departments in Denmark. The intervention group was offered the Gold Standard P...

Patients with hazardous alcohol intake are overrepresented in emergency departments and surgical wards. These patients have an increased risk of postoperative complications with prolonged hospital stays and admissions to intensive care unit after surgery. In elective surgery, preoperative alcohol cessation interventions can reduce postoperative com...

Tobacco smoking is more prevalent among the elderly than among the young, and the elderly also have the most frequent contact with the health care system. The aim of this study was to evaluate the effectiveness of the Gold Standard Program, which is an intensive six-week smoking cessation program, on continuous self-reported abstinence rates after...