Peri-operative tobacco cessation interventions: a systematic review and meta-analysis

Area of Science:

• Medical Research
• Public Health
• Surgical Oncology

Background:

• Tobacco smoking substantially elevates the risk of postoperative complications.
• The peri-operative period presents a critical window for smoking cessation interventions to mitigate risks and enhance long-term health.
• Evidence for the efficacy of tobacco cessation interventions in surgical patients requires systematic review.

Approach:

• Conducted a systematic review of randomized controlled trials (RCTs) focusing on peri-operative tobacco cessation.
• Performed a random-effects meta-analysis to synthesize abstinence outcomes at surgery and 12 months post-surgery.
• Analyzed 38 studies (7310 participants) and included 26 studies (5969 participants) in the meta-analysis, with subgroup analyses based on intervention timing and intensity.

Key Points:

• Peri-operative interventions demonstrated increased successful abstinence at surgery (RR 1.48, NNT 7) and at 12 months post-surgery (RR 1.62, NNT 9).
• The quality of evidence was judged as moderate due to heterogeneity and high risk of bias in included studies.
• Interventions were effective regardless of timing or intensity, suggesting broad applicability.

Conclusions:

• Peri-operative tobacco cessation interventions are effective in improving smoking abstinence rates.
• Further research is needed to optimize intervention design, delivery, and integration into surgical pathways.
• Standardized outcome measures are recommended for future clinical trials in this area.