Offering mailed nicotine replacement therapy and Quitline support before elective surgery: a randomised controlled...

Area of Science:

• Public Health
• Clinical Interventions
• Smoking Cessation

Background:

• Smokers on elective surgery waiting lists represent a key population for smoking cessation interventions.
• Pre-operative smoking cessation is associated with improved surgical outcomes.
• Limited research exists on the effectiveness of mailed nicotine replacement therapy (NRT) and telephone counseling for this group.

Purpose of the Study:

• To evaluate if providing free mailed NRT and telephone counseling to patients awaiting elective surgery increases smoking cessation prior to their operation.

Main Methods:

• A randomized controlled trial was conducted at Frankston Hospital involving adult smokers on elective surgery waiting lists.
• The intervention group received NRT (lozenges and patches) and an offer of telephone counseling, in addition to standard care.
• The primary outcome was verified smoking cessation at least 24 hours before surgery, with secondary outcomes including longer-term abstinence.

Main Results:

• 32% of intervention participants accepted cessation support. Significantly higher proportions of the intervention group quit smoking at least 24 hours (18% vs 9%) and four weeks (9% vs 4%) before surgery compared to the control group.
• Post-surgery abstinence rates at three months were similar between groups for those who quit pre-operatively.
• No major adverse events were reported.

Conclusions:

• Mailed NRT and telephone counseling interventions show good uptake among surgical patients.
• This approach is effective in increasing the proportion of smokers who quit before undergoing elective surgery.
• Further research could explore long-term cessation maintenance and cost-effectiveness.