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, in patients awaiting a wide range elective surgeries. In all thestudies (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- 4 weeks before surgery:
Might be effective (1 strong quality study showing a significant effect for intervention when compared to control) (4).
Abstinence- immediately after surgery:
Might not be effective (1 strong quality study showing no effect for intervention when compared to control) (3).
Abstinence- 30days after surgery:
Might be effective (1 moderate quality study showing a significant effect for intervention when compared to control) (1).
Abstinence- 6 months after surgery:
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Abstinence- 12 months after surgery:
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Smoking reduction- preoperative:
Might be effective (1 moderate quality study showing significant effect for intervention when compared to control) (1).
Smoking reduction- 30 days after surgery:
Might be effective (1 moderate quality study showing significant effect for intervention when compared to control) (1).
Successful quit attempts sustained more than 24hrs- preoperative:
Might be effective (1 strong quality study showing a significant effect for intervention when compared to control) (4).
Nicotine dependence- 3 months after surgery:
Might not be effective (1 moderate quality study showing no effect for intervention when compared to control) (5).
Number of days without having smoked- before surgery:
Might not be effective (1 moderate quality study showing no effect for intervention when compared to control) (1).
Surgical and postoperative complications:
Might be effective (1 moderate quality study showing no difference between intervention and control) (1).