A pilot randomized trial of a virtual perioperative smoking cessation bundle in a tertiary care hospital

Smokers have increased complications after surgery. We sought to study the feasibility of a structured virtual smoking cessation bundle.

We conducted a pilot parallel randomized controlled trial involving adult smokers scheduled for elective surgery 1 or more weeks after enrolment. The intervention bundle consisted of an emailed video and brochure, QuitNow referral, and pharmacy referral. The control group received usual care of uncoordinated advice on smoking cessation. Perioperative caregivers, but not participants, were blinded to group allocation. The primary outcome was the participant's self-reported uptake of smoking cessation information and available resources.

We enrolled the target 30 patients (15 intervention and 15 control). The recruitment rate was 0.8 patients/wk; 59% (30/51) of all eligible patients were enrolled. By day of surgery, 1 patient withdrew from the study and 1 was lost to follow-up. The median (interquartile range [IQR]) number of smoking cessation resources used was higher in the intervention group than in the control group on the day of surgery (1 [IQR 1 to 3] v. 0 [IQR 0-1], p = 0.002), 30 days after surgery (1 [IQR 0 to 2] v. 0 [IQR 0 to 0], p = 0.01), and 8 weeks after randomization (1 [IQR 0 to 1] v. 0 [IQR 0 to 0], p = 0.003), but not different at 6-month follow-up (1 [IQR 0 to 1] v. 0 [IQR 0 to 0], p = 0.1).

Patients in the intervention group reported more use of smoking cessation resources than those in the control group. This pilot trial demonstrated that a virtually delivered preoperative smoking cessation bundle was feasible and acceptable to patients.

ClinicalTrials.gov, no. NCT04487548.