Interventions for preoperative smoking cessation effective Clinical

Clinical question: 
How effective are preoperative interventions on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications?
Bottom line: 
Based on indirect comparisons and evidence from 2 small trials, interventions that begin 4 to 8 weeks before surgery and which include weekly counselling, and nicotine replacement therapy, are more likely than standard care to have an impact on complications and on long-term smoking cessation. None of the studies reported any adverse effects of preoperative smoking intervention.
Caveat: 
This review included 8 studies addressing smoking cessation but only 5 of them addressed postoperative complications. Six trials testing brief interventions increased smoking cessation at the time of surgery, but failed to detect a statistically significant effect on postoperative morbidity. The optimal preoperative intervention intensity remains unknown.
Context: 
Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions.
Review CD#: 
CD002294
PEARLS No: 
278
Date: 
August, 2010
Authored by: 
Brian R McAvoy