A Perioperative Smoking Cessation Intervention With Varenicline, Counseling, and Fax Referral to a Telephone Quitline Versus a Brief Intervention: A Randomized Controlled Trial.
The effectiveness of perioperative interventions to quit smoking with varenicline has not been compared with brief interventions. Our objective was to determine the efficacy of a comprehensive smoking cessation program versus a brief intervention for smoking cessation.



In this prospective, multicenter study, 296 patients were randomized to participate in a smoking cessation program (one 10- to 15-minute counseling session, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a telephone quitline); or brief advice and self-referral to a telephone quitline. The primary outcome was the 7-day point prevalence (PP) abstinence at 12 months after surgery. Secondary outcomes included abstinence at 1, 3, and 6 months. Multivariable generalized linear regression was used to identify independent variables related to abstinence.



The 7-day PP abstinence for the smoking cessation program versus brief advice group was 42.4% vs 26.2% (relative risk [RR], 1.62; 95% confidence interval [CI], 1.16-2.25; P = .003) at 12 months. The 7-day PP abstinence at 1, 3, and 6 months was higher in the smoking cessation group versus the brief advice group: 45.7% vs 25.5% (RR, 1.79; 95% CI, 1.29-2.49; P < .001), 46.4% vs 26.9% (RR, 1.72; 95% CI, 1.25-2.37; P< .001), and 45.0% vs 26.2% (RR, 1.72; 95% CI, 1.24-2.38; P < .001), respectively. Participating in the smoking cessation group predicted abstinence at 12 months (RR, 1.58; 95% CI, 1.12-2.21; P = .0087).



A perioperative smoking cessation program with counseling, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a quitline increased abstinence from smoking 1, 3, 6, and 12 months after surgery versus a brief intervention.
From the *Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada; †Department of Anesthesia, Mount Sinai Hospital, University of Toronto, Ontario, Canada; ‡Department of Pharmacy, Mount Sinai Hospital, Toronto, Ontario, Canada; §Departments of Family and Community Medicine and Psychiatry, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; and ‖Addictions Program and Ontario Tobacco Research Unit, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada.
Jean
J
Wong
Amir
A
Abrishami
Sheila
S
Riazi
Naveed
N
Siddiqui
Eric
E
You-Ten
Jennifer
J
Korman
Sazzadul
S
Islam
Xin
X
Chen
Maged S M
MSM
Andrawes
Peter
P
Selby
David T
DT
Wong
Frances
F
Chung
D000368:Aged; D057186:Comparative Effectiveness Research; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018722:Nicotinic Agonists / Q000627:therapeutic use; D010353:Patient Education as Topic; D059035:Perioperative Period; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation; D012306:Risk; D012907:Smoking; D016540:Smoking Cessation; D016636:Telefacsimile; D013689:Telephone; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D000068580:Varenicline / Q000627:therapeutic use*
D018722:Nicotinic Agonists; D000068580:Varenicline