title: Smoking cessation after surgery. A randomized trial.
abstract: BACKGROUND
  Cigarette smoking is the greatest cause of preventable mortality in the United States. Because most smokers would like to quit and most hospitals are smoke free, surgical admissions represent a window of opportunity for tobacco cessation interventions.
  
  
  METHODS
  A total of 324 patients (98% men), aged 25 to 82 years, who were current smokers and who underwent noncardiac surgery were enrolled in a randomized controlled trial at the Veterans Affairs Medical Center, San Francisco, Calif. One hundred sixty-eight participants (52%) received a multicomponent intervention designed to increase self-efficacy and coping skills that included face-to-face in-hospital counseling, viewing a smoking cessation videotape, self-help literature, nicotine replacement therapy, and 3 months of telephone follow-up. One hundred fifty-six participants (48%) received self-help literature and brief counseling lasting 10 minutes. Serum or saliva cotinine levels were measured to confirm self-reported smoking cessation.
  
  
  RESULTS
  At 12 months of follow-up, the self-reported quit rate was 27% among the intervention group and 13% among the comparison group (relative risk, 2.1; 95% confidence interval, 1.2-3.5; P < .01). Based on biochemical confirmation, 15% of the intervention group, compared with 8% of the comparison group, quit smoking at 12 months (relative risk, 2.0; 95% confidence interval, 1.0-3.9; P = .04).
  
  
  CONCLUSIONS
  A smoking cessation intervention targeted at smokers hospitalized for noncardiac surgery can increase long-term quit rates. Surgical hospitalizations provide an opportunity to reach smokers who want to quit smoking.
authors.affiliation: General Internal Medicine Section, Department of Veterans Affairs Medical Center, San Francisco, Calif, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Simon
authors.forename: S N
authors.initials: SN
authors.lastname: Solkowitz
authors.forename: T P
authors.initials: TP
authors.lastname: Carmody
authors.forename: W S
authors.initials: WS
authors.lastname: Browner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003131:Combined Modality Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D016540:Smoking Cessation; D013514:Surgical Procedures, Operative