CAN J ANESTH 55: 1 www.cja-jca.org Januar y, 2008 Purpose: To assess the efficacy of interventions offered to patients in the preoperative clinic to promote long-term (≥ three months) smoking cessation following surgery.
Methods:We searched The Cochrane Library, MEDLINE, EMBASE and CINAHL for all randomized controlled trials (RCTs) on smoking-cessation interventions initiated in the preoperative clinic. Trial inclusion, quality assessment, and data extraction were performed independently by two authors. Standard meta-analytic techniques were applied.Results: Four RCTs (n = 610 patients) were included in the review. Interventions included pharmacotherapy, counseling, educational literature and postoperative telephone follow-up. The follow-up period ranged between three to 12 months with only one RCT following up patients for > one year. Two studies used biochemical methods to validate subjects' self-reporting of smoking cessation at the follow-up assessment. Overall, the interventions were associated with a significantly higher cessation rate vs control at the three to six month follow-up period (pooled odds ratio: 1.58, 95% confidence interval (CI) 1.02-2.45, P value = 0.01, I 2 = 0%). The only trial with longer follow-up period (12 months), however, failed to show any significant difference between the intervention and control groups (odds ratio: 1.05, 95% CI 0.53-2.09, P value = 0.88).
Conclusion:This systematic review suggests that smokingcessation interventions initiated at the preoperative clinic can increase the odds of abstinence by up to 60% within a three-to six-month follow-up period. To evaluate the possibility of longer abstinence, future trials with at least one-year follow-up are recommended.
Objectif : Évaluer l'efficacité des interventions destinées à promouvoir la cessation du tabagisme à long terme (≥ trois mois) après une chirurgie mises à la disposition des patients en clinique préopératoire.
Méthode : Nous avons effectué des recherches dans la Bibliothèque Cochrane et les bases de données MEDLINE, EMBASE et CINAHL pour identifier toutes les études randomisées contrôlées (ERC) traitant des interventions de cessation du tabagisme mises en