title: Will preoperative smoking cessation programs generate long-term cessation? A systematic review and meta-analysis.
abstract: OBJECTIVE
  The aim of this review was to examine published randomized controlled trials (RCTs) and quasi-experimental studies that evaluate the association between preoperative smoking cessation programs and long-term smoking cessation at a minimum of 6 months, postoperatively.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  A systematic review was performed utilizing MEDLINE, EMBASE, CINAHL, PSYCHinfo, and COCHRANE databases. All eligible studies of smoking-cessation interventions initiated preoperatively, with cessation measured at a minimum of 6 months postoperatively, were identified. The effect of cessation interventions at 12 months postoperatively in RCTs was evaluated through meta-analyses using Mantel-Haenszel risk ratios (RRs) and 95% CIs. A fixed effects model was conducted initially; however, due to heterogeneity in study characteristics and patient cohorts, a more conservative random effects model was also performed.
  
  
  RESULTS
  Four RCTs and 4 quasi-experimental studies were included. Two RCTs demonstrated an association between interventions and cessation at 12 months, and the quasi-experimental studies showed cessation rates of 48% to 56% at 12 months, postoperatively. In a fixed effects model, interventions were associated with a greater likelihood of cessation at 12 months (RR, 1.50; 95% CI, 1.05-2.15; P = .02), although this effect was not statistically significant after applying a random effects model (RR, 1.61; 95% CI, 0.88-2.96; P = .12).
  
  
  CONCLUSIONS
  The literature suggests that preoperative smoking cessation programs will likely precipitate long-term (≥12 months) cessation. Additional studies should identify approaches that optimize preoperative cessation programs in the promotion of short-term, and long-term cessation.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Berlin
authors.forename: Christina
authors.initials: C
authors.lastname: Cutter
authors.affiliation: University of Colorado School of Public Health, 13808, East 19th Ave, Mail Stop 8700, Aurora, CO 80045. E-mail: Catherine.Battaglia@ucdenver.edu.
authors.forename: Catherine
authors.initials: C
authors.lastname: Battaglia
mesh_terms: D006801:Humans; D011184:Postoperative Period; D057234:Preoperative Period; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data