Smokers who viewed packages with graphic images plus text warnings demonstrated more negative implicit attitudes compared to other smokers. Macy JT, Chassin L, Presson CC, Yeung E. Exposure to graphic warning labels on cigarette packages: Effects on implicit and explicit attitudes towards smoking among young adults. Psychol Health. 2016;31(3):349-63.
The quitline facilitation intervention did not improve self-reported abstinence rates compared with a standard brief stop-smoking intervention. Warner DO, Nolan MB, Kadimpati S, Burke MV, Hanson AC, Schroeder DR. Quitline Tobacco Interventions in Hospitalized Patients: A Randomized Trial. Am J Prev Med. 2016 Apr 7. pii: S0749-3797(16)30025-3.
Self-reported abstinence rates were significantly higher among participants who were sent nicotine patches without any behavioral support compared with the control group. Cunningham JA, Kushnir V, Selby P, Tyndale RF, Zawertailo L, Leatherdale ST. Effect of Mailing Nicotine Patches on Tobacco Cessation Among Adult Smokers: A Randomized Clinical Trial. JAMA Intern Med. 2016 Feb;176(2):184-90.
Among adults motivated to quit smoking, 12 weeks of open-label treatment with nicotine patch, varenicline, or C-NRT produced no significant differences in biochemically confirmed rates of smoking abstinence at 26 weeks. Baker TB, Piper ME, Stein JH, Smith SS, Bolt DM, Fraser DL, Fiore MC. Effects of Nicotine Patch vs Varenicline vs Combination Nicotine Replacement Therapy on Smoking Cessation at 26 Weeks: A Randomized Clinical Trial. JAMA. 2016 Jan 26;315(4):371-9.
Smoking reduction support plus medication significantly increased the long-term cessation of smokers without an intention to quit compared to reduction support plus placebo. Wu L, Sun S, He Y, Zeng J. Effect of Smoking Reduction Therapy on Smoking Cessation for Smokers without an Intention to Quit: An Updated Systematic Review and Meta-Analysis of Randomized Controlled. Int J Environ Res Public Health. 2015 Aug 25;12(9):10235-53.
Smoking reduction is a promising intervention; however, the benefits are only observed when it leads to permanent cessation. Begh R, Lindson-Hawley N, Aveyard P. Does reduced smoking if you can't stop make any difference? BMC Med. 2015 Oct 12;13:257.
Use of NRT for less than 4 weeks was associated with reduced likelihood of cessation, whereas NRT use for longer periods of time was associated with a higher likelihood of cessation. Bo Zhang, Joanna E. Cohen, Susan J. Bondy, and Peter SelbyDuration of Nicotine Replacement Therapy Use and Smoking Cessation: A Population-Based Longitudinal Study. Am. J. Epidemiol. Online. March 3, 2015
Total smoking cessation of 4 weeks preoperatively and lasting until primary healing of the operative site (min. 2 weeks) appears to optimize surgical conditions without heightening anesthetic risk. Pluvy I, Garrido I, Pauchot J, Saboye J, Chavoin JP, Tropet Y, Grolleau JL, Chaput B. Smoking and plastic surgery, part I. Pathophysiological aspects: update and proposed recommendations. Ann Chir Plast Esthet. 2015 Feb;60(1):e3-e13.
Only 54.4% of patch users and 32.2% of non-transdermal NRT users reported using NRT with a frequency that would be expected to substantially influence cigarette consumption. Beard E, Bruguera C, McNeill A, Brown J, West R. Association of amount and duration of NRT use in smokers with cigarette consumption and motivation to stop smoking: a national survey of smokers in England. Addict Behav. 2015 Jan;40:33-8.
Results indicated that younger smokers, non-White smokers, and smokers reporting higher income, lower nicotine dependence, shorter smoking history, and higher lifetime quit attempts were more likely to have tried e-cigarettes but not NRT products for help with smoking cessation. Pokhrel P, Little MA, Fagan P, Kawamoto CT, Herzog TA. Correlates of use of electronic cigarettes versus nicotine replacement therapy for help with smoking cessation. Addict Behav. 2014 Dec;39(12):1869-73.
E-cigarette users were more likely to report abstinence than either those who used NRT bought over-the-counter (OR = 2.23) or no aid (OR = 1.38). Brown J, Beard E, Kotz D, Michie S, West R. Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction. 2014 Sep;109(9):1531-40.
The 52-week abstinence rate for patients using varenicline was 42.8% versus 31.0% in those using their choice of NRT. Kralikova E, Kmetova A, Stepankova L, Zvolska K, Davis R, West R. Fifty-two-week continuous abstinence rates of smokers being treated with varenicline versus nicotine replacement therapy. Addiction. 2013 Aug;108(8):1497-502.
A perioperative smoking cessation intervention with varenicline increased abstinence from smoking 3, 6, and 12 months after elective noncardiac surgery with no increase in serious adverse events. Wong J, Abrishami A, Yang Y, Zaki A, Friedman Z, Selby P, Chapman KR, Chung F. A perioperative smoking cessation intervention with varenicline: a double-blind, randomized, placebo-controlled trial. Anesthesiology. 2012 Oct;117(4):755-64.
Adding NRT to intensive counselling significantly increases cessation rates over counselling alone. Rigotti NA, Clair C, Munafò MR, Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev. 2012 May 16;(5):CD001837.
There is evidence that preoperative smoking interventions including NRT increase short-term smoking cessation and may reduce postoperative morbidity. Thomsen T, Villebro N, Møller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD002294.
Undergoing surgery is associated with an increased likelihood of smoking cessation in the older U.S. population. Cessation is more likely in association with major procedures compared with outpatient surgery. Shi Y, Warner DO. Surgery as a teachable moment for smoking cessation. Anesthesiology. 2010 Jan;112(1):102-7
Intensive interventions increased smoking cessation rates both before operation and up to 12 months thereafter. Thomsen T, Tønnesen H, Møller AM. Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation. Br J Surg. 2009 May;96(5):451-61.
Smoking cessation interventions prior to surgery are effective in helping patients to quit smoking; however, such effects appear to be short-lived. Cropley M, Theadom A, Pravettoni G, Webb G. The effectiveness of smoking cessation interventions prior to surgery: a systematic review. Nicotine Tob Res. 2008 Mar;10(3):407-12.
Routine nicotine replacement therapy is not indicated in smokers undergoing surgery for the purposes of managing nicotine withdrawal and stress but can modify some aspects of postoperative smoking behavior. Warner DO, Patten CA, Ames SC, Offord KP, Schroeder DR: Effect of nicotine replacement therapy on stress and smoking behavior in surgical patients. Anesthesiology 2005; 102:1138–46
Although smokers report increased baseline stress, smoking status does not affect changes in perceived stress over the perioperative period. Nicotine withdrawal symptoms do not seem to be a clinically significant problem in the perioperative period for most smokers. Warner DO, Patten CA, Ames SC, Offord K, Schroeder D: Smoking behavior and perceived stress in cigarette smokers undergoing elective surgery. Anesthesiology 2004; 100:1125–37
Intervention opportunities are not exploited consistently in the surgical population: more than 90% of anesthesiologists and surgeons almost always ask their patients about tobacco use. Most believed that it was their responsibility to advise their patients to quit smoking, but only 30% of anesthesiologists and 58% of surgeons routinely do so. Approximately 70% of both groups would be willing to spend an extra 5 min before surgery to help their patients quit. Barriers to intervention included a lack of training regarding intervention techniques, a perceived lack of effective interventions, and insufficient time to intervene. Warner DO, Sarr MG, Offord K, Dale LC: Anesthesiologists, general surgeons, and tobacco interventions in the perioperative period. Anesth Analg 2004; 99:1776–83
Patients receiving bupropion had a lower daily cigarette consumption at the time of hospital admission, median (IQR) cigarettes per day: 6 (2-7) vs. 15 (9-20), p = 0.046. They were more likely to have stopped smoking at the 3-week visit (p = 0.036), but not at the 6-week visit or at the time of hospital admission for surgery. This study found that smokers waiting for elective surgery are more likely to reduce or stop smoking when treated with bupropion. Myles PS, Leslie K, Angliss M, Mezzavia P, Lee L: Effectiveness of bupropion as an aid to stopping smoking before elective surgery: A randomised controlled trial. Anaesthesia 2004; 59:1053–8
Encouraging patients to fast from smoking before surgery and postoperative support are efficacious ways to reduce preoperative and immediate post-operative tobacco use. Ratner PA, Johnson JL, Richardson CG, Bottorff JL, Moffat B, Mackay M, Fofonoff D, Kingsbury K, Miller C, Budz B: Efficacy of a smoking-cessation intervention for elective-surgical patients. Res Nurs Health 2004; 27:148–61
Patients with a good social network were more likely to successfully quit smoking and moking intervention programs in health care settings are highly effective in reducing postoperative risks in hip and knee arthroplasty. Møller AM, Pedersen T, Villebro N, Norgaard P. Impact of lifestyle on perioperative smoking cessation and postoperative complication rate. Preventive Medicine. 2003;36:704–709.
The label "teachable moment" has been used to describe naturally occurring health events thought to motivate individuals to spontaneously adopt risk-reducing health behaviors. Cessation rates associated with pregnancy, hospitalization and disease diagnosis were high (10-60 and 15-78%, respectively), whereas rates for clinic visits and abnormal test results were consistently lower (2-10 and 7-21%, respectively). McBride CM, Emmons KM, Lipkus IM: Understanding the potential of teachable moments: The case of smoking cessation. Health Educ Res 2003; 18:156–70
Patients who smoke are not routinely informed of the risks of tobacco use or the benefits of abstinence before surgery; counseling has a positive impact on the patient's smoking behavior in the 24 hours preceding surgery. Shannon-Cain J, Webster SF, Cain BS: Prevalence of and reasons for preoperative tobacco use. AANA J 2002; 70:33–40
Efficacious inpatient smoking programs have been developed and validated. For example, studies with a dedicated smoking cessation counselor and 3-5 months of relapse prevention had a significant impact on cessation rates. France EK, Glasgow RE, Marcus AC: Smoking cessation interventions among hospitalized patients: What have we learned? Prev Med 2001; 32:376–88
The longer a patient is abstinent preoperatively, the more likely he or she is to remain abstinent postoperatively. Dresler CM, Bailey M, Roper CR, Patterson GA, Cooper JD. Smoking cessation and lung cancer resection. Chest. 1996 Nov;110(5):1199-202.
Transdermal nicotine plus support produces a relative increase of 50% in smoking cessation over placebo in hospital patients. Campbell IA, Prescott RJ, Tjeder-Burton SM. Transdermal nicotine plus support in patients attending hospital with smoking-related diseases: a placebo-controlled study. Respir Med. 1996 Jan;90(1):47-51.
While wearing nicotine patches the subjects did not reduce the number of cigarettes smoked, but their expired carbon monoxide was reduced by 14%, they obtained less satisfaction from their cigarettes, and reported fewer and weaker urges to smoke. Foulds J, Stapleton J, Feyerabend C, Vesey C, Jarvis M, Russell MA: Effect of transdermal nicotine patches on cigarette smoking: A double blind crossover study. Psychopharmacology 1992; 106:421–7