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Published in: Trials 1/2022

Open Access 01-12-2022 | Study protocol

Preoperative smoking cessation program in patients undergoing intermediate to high-risk surgery: a randomized, single-blinded, controlled, superiority trial

Authors: Christian D. Fankhauser, Andres Affentranger, Beatrice Cortonesi, Urs Jeker, Markus Gass, Fabrizio Minervini, Georg Jung, Corina Christmann, Christine Brambs, Milo A. Puhan, Ulrike Held

Published in: Trials | Issue 1/2022

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Abstract

Background

At present, effectively implementing smoking cessation programs in the health care system constitutes a major challenge. A unique opportunity to initiate smoking cessation focuses on smokers scheduled for surgery. These patients are not only highly motivated to quit smoking but also likely to benefit from a reduction in postoperative complications which may translate into a decrease of costs. Nevertheless, surgical patients are not routinely informed about the benefits of preoperative smoking cessation. Potential reasons for this missed opportunity may be the lack of time and training of surgeons and anaesthesiologists. We therefore aim to analyse the impact of a preoperative high-intensity smoking cessation intervention on surgical complications up to a 90-day postoperative period in patients of various surgical disciplines. The hypothesis is that a preoperative smoking cessation program improves outcomes in smokers undergoing intermediate to high-risk surgery.

Methods

The present study is a single-centre, randomized trial with two parallel groups of smokers scheduled for surgery comparing surgery alone and surgery with preoperative smoking cessation. We plan to randomize 251 patients. The primary objective is to compare complications between patients with an institutional multifaceted smoking cessation intervention starting 4 weeks before surgery compared to patients in the advice-only group (control group) within a 90-day postoperative period. The primary endpoint is the Comprehensive Complication Index (CCI®) within 90 days of surgery. Secondary outcomes include the length of hospital stay, cost of care, quality of life, smoking abstinence, and reduction in nicotine consumption.

Discussion

The hypothesis is that a preoperative smoking cessation program improves outcomes in smokers undergoing surgery.

Trial registration

BASEC #2021-02004; ClinicalTrials.gov: NCT05192837. Registered on January 14, 2022.
Appendix
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Metadata
Title
Preoperative smoking cessation program in patients undergoing intermediate to high-risk surgery: a randomized, single-blinded, controlled, superiority trial
Authors
Christian D. Fankhauser
Andres Affentranger
Beatrice Cortonesi
Urs Jeker
Markus Gass
Fabrizio Minervini
Georg Jung
Corina Christmann
Christine Brambs
Milo A. Puhan
Ulrike Held
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06628-8

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