Preoperative smoking cessation: Is it a trigger for long-term abstinence?
Yanay Shaked, Joseph Azuri, Tomer Tzur and 1 others
PMID 41657035WHAT IT FOUND
Plastic surgery patients who complied with preoperative smoking cessation instructions were not significantly more likely to be abstinent at 1 year.
They had a longer median time before relapse: 2 months versus < 1 month.
Key findings
01Compliance with preoperative smoking cessation instructions was not significantly associated with long-term abstinence at 1 year: 6 of 47 patients (12.8%) versus 3 of 41 patients (7.3%), p = 0.49.
02Preoperative compliance was associated with a longer time to smoking relapse: median 2 months versus < 1 month, p < 0.001, and a Cox regression hazard ratio of 0.41 (95% CI 0.26-0.65, p < 0.001).
03In the whole cohort, univariate logistic regression did not identify predictors of long-term abstinence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The design was retrospective and relied on patients' recall of when they returned to smoking. Smoking status was self-reported and not checked with biochemical testing such as cotinine. Only 88 of 112 eligible patients completed the telephone interview, and the sample was small, so modest differences in long-term abstinence could have been missed. The study did not test a formal cessation intervention, so it does not show whether counselling, nicotine replacement, or other support would improve long-term abstinence. Only patients having specific plastic surgeries involving significant tissue dissection were included, so the findings may not apply to other surgical populations.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication.
The easy way to misread this
Do not conclude that preoperative smoking instructions cause long-term abstinence. The primary outcome, continuous abstinence for at least 1 year, was not significantly different: 12.8% in the compliant group versus 7.3% in the non-compliant group, p = 0.49. The study also did not test a cessation intervention, so it cannot show that instructions alone caused the longer relapse time.