Five studies, two strong quality (3, 4), two moderate quality (1, 5) and one weak quality (2) examined the effectiveness of multicomponent smoking cessation interventions in abstaining from tobacco use immediately before surgery, sustaining their abstinence in the postoperative period as well as maintaining long-term abstinence, inpatients awaiting a wide range elective surgeries. In all the studies (1-5), the support continued in-hospital and postoperatively. The elective surgical patients were enrolled from surgical services including dental, head and neck, cardiovascular, general surgery, ophthalmology, orthopaedic, neurosurgical, plastics, obstetrics/gynaecology and urology.
The interventions comprised of one or more components including nicotine replacement therapy (1-5), self-help materials (1-5), brief counselling (1, 2, 5), education (1, 3), Quitline referral (1, 2, 4), bupropion hydrochloride (2) and prompts to quit (5). The comparison groups consisted of usual care which may have included routine smoking cessation advice.
Abstinence- 24hr before surgery:
Might be effective (5 studies; 4 [1 strong (4), 2 moderate (1, 5), 1 weak quality (2)] showing significant effect in the intervention group compared to control. One [strong quality] (3) showing no effect in the intervention group compared to control).
Number of cigarettes/day preoperatively:
Might be effective (3 Studies; 2 [1strong (4), 1 moderate quality] (1) showing a significant reduction, and one [strong quality] (3) showing no effect in the intervention group when compared to control).
Severe adverse events including unanticipated hospital admissions:
Might be effective (3 Studies; 2 strong (3, 4), 1 moderate quality (1). All showing no difference in adverse events between intervention and control).