Will preoperative smoking cessation programs generate long-term cessation? A systematic review and meta-analysis

Area of Science:

• Medical research
• Public health
• Surgical outcomes

Background:

• Smoking is a significant risk factor for adverse surgical outcomes.
• Preoperative smoking cessation interventions aim to improve patient health and surgical results.
• Long-term cessation data from preoperative programs require further investigation.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) and quasi-experimental studies.
• To evaluate the association between preoperative smoking cessation programs and long-term smoking cessation (≥6 months postoperatively).

Main Methods:

• Systematic review and meta-analysis of studies from multiple databases (MEDLINE, EMBASE, CINAHL, PSYCHinfo, COCHRANE).
• Inclusion of interventions initiated preoperatively with cessation measured ≥6 months postoperatively.
• Meta-analyses performed using Mantel-Haenszel risk ratios (RRs) with fixed and random effects models.

Main Results:

• Eight studies (4 RCTs, 4 quasi-experimental) were included.
• Two RCTs indicated an association between interventions and 12-month cessation.
• Quasi-experimental studies reported 12-month cessation rates of 48-56%.
• Fixed effects model showed a significant association (RR 1.50, P=.02), but random effects model did not (RR 1.61, P=.12).

Conclusions:

• Preoperative smoking cessation programs are likely to lead to long-term cessation (≥12 months).
• Further research is recommended to identify optimal approaches for preoperative cessation programs.
• Optimized programs could enhance both short-term and long-term smoking cessation rates.