Preoperative smoking cessation interventions: a systematic review and meta-analysis
Alsanad, Mohammed Aljanoubi, Mohammed Alenezi, Faraj K Farley, Amanda Naidu, Babu Yeung, Joyce
Alsanad, Mohammed
Aljanoubi, Mohammed
Alenezi, Faraj K
Farley, Amanda
Naidu, Babu
Yeung, Joyce
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2025-01-10
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Abstract
Smoking is the leading single cause of preventable death in England and also increases the risk of postoperative complications. The preoperative period is a potential opportunity to introduce smoking cessation interventions to smokers to reduce the risk of postoperative complications. A systematic search was conducted to find all studies that investigated the effectiveness of preoperative smoking cessation interventions. The primary outcome was smoking cessation at surgical time to the last follow-up, and the secondary outcome was postoperative complications that required treatment or ICU admission. A random-effects meta-analysis was used to synthesize the outcomes. Sixteen studies were included in the review (3505 participants), and 14 studies were included in the meta-analysis (2940 randomized participants). The quality of evidence was moderate due to the high risk of bias and heterogeneity. We found that patients who were provided with a smoking cessation intervention had significantly increased odds of quitting smoking by the time of surgery compared with usual care, with a reported relative risk (95% CI) 1.64 (1.30-2.07) and at the longest follow-ups with RR (95% CI) 1.38 (1.12-1.70). Moreover, there was no difference found in the rate of postoperative complications between intervention and control conditions with RR (95% CI) 0.81 (0.62-1.06). The use of standardized outcome measurements is recommended to reduce heterogeneity for future studies, and further investigation focusing on patient perspectives is needed.
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Alsanad M, Aljanoubi M, Alenezi FK, Farley A, Naidu B, Yeung J. Preoperative smoking cessation interventions: a systematic review and meta-analysis. Perioper Med (Lond). 2025 Jan 10;14(1):5. doi: 10.1186/s13741-024-00479-4.
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Review