Effect of a Perioperative Smoking Cessation Program on Smoking Cessation/Reduction and Perioperative Complications

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01260233
Recruitment Status : Completed
First Posted : December 15, 2010
Last Update Posted : August 26, 2013
University of Western Ontario, Canada
Information provided by (Responsible Party):
Philip Jones, Lawson Health Research Institute

December 13, 2010
December 15, 2010
August 26, 2013
October 2010
May 2012   (Final data collection date for primary outcome measure)
smoking cessation [ Time Frame: date of surgery ]
Smoking cessation is defined as exhaled carbon monoxide (CO) of equal to or less than 7ppm on the day of surgery.
Same as current
Complete list of historical versions of study NCT01260233 on Archive Site
  • smoking cessation/reduction [ Time Frame: day of surgery ]
    Smoking cessation/reduction by self-report. Smoking cessation defined as zero cigarettes in the 7 days before surgery (but exhaled CO > 7ppm) Reduction defined as 50% or less of initial self-report.
  • Intraoperative complications and immediate post-operative complications [ Time Frame: day of surgery ]

    Events occurring in the operating room or post-anesthetic care unit (PACU) as reported by a blinded anesthesiologist or blinded PACU nurse:

    Cardiovascular complications, Respiratory complications, Other (detailed description exceeds character limits)

  • Time until PACU readiness for discharge / actual time in PACU [ Time Frame: day of surgery ]

    The time of arrival in PACU until the time the patient is deemed ready for discharge in accordance with hospital routine scoring system. The actual time spent in PACU (arrival until discharge) will also be compared.

    Patients bypassing PACU (e.g. patients having only sedation transferred directly from the operating room to surgical daycare prior to discharge home) will be considered separately.

  • Unanticipated hospital admission [ Time Frame: day of surgery ]
    Patient booked as one-day stay, but later admitted to inpatient ward.
  • Hospital length of stay [ Time Frame: until hospital discharge ]
    For inpatients only, the time from admission to surgical daycare until the patient is discharged home from the hospital.
  • Smoking cessation at 12 months [ Time Frame: 1 year ]
    Self-reported smoking zero cigarettes in the 7 days prior to phone call. Phone call will occur at any time during the 12th month after surgery.
Same as current
Not Provided
Not Provided
Effect of a Perioperative Smoking Cessation Program on Smoking Cessation/Reduction and Perioperative Complications
The Effect of a Perioperative Smoking Cessation Program on Rates of Smoking Cessation/Reduction and Perioperative Complications: a Randomized Clinical Trial.
The purpose of this study is to determine whether a perioperative smoking cessation program, implemented at least 3 weeks prior to elective surgery, is effective in increasing rates of smoking cessation or reduction. Intraoperative and immediate postoperative complications will also be compared.

Previous studies have shown that patients have up to one-third fewer complications after surgery when they quit smoking at least several weeks before surgery. Nicotine replacement therapy (which relieves cravings for cigarettes) and support by healthcare professionals have been shown to help patients quit smoking, particularly when encountering a major health event (e.g. surgery). In addition, quitting smoking in preparation for surgery sometimes results in quitting for a longer period of time after surgery, giving these patients the health benefits of long-term smoking cessation such as reduced rates of cancer and heart disease.

The preadmission clinic at St. Joseph's Health Care, London, Ontario, is assessing how effective a new 'Stop Smoking' program is for patients preparing for surgery. The program will include brief counselling in the clinic, smoking cessation brochures, six weeks of free transdermal nicotine replacement therapy and a referral to the Canadian Cancer Society's Smokers' Helpline telephone advice line. Patients that are smokers and preparing for their elective surgery will be invited to join the study, then be assigned to a group that either participates in the program or not. These groups will then be compared in terms of success at quitting smoking and complication rates around the time of surgery.

Not Applicable
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
  • Smoking
  • Tobacco Use
Other: Smoking cessation program

Smoking cessation program includes:

  • brief smoking cessation counselling by preadmission nurse (less than 5 minutes)
  • smoking cessation brochures
  • referral to the Smokers' Helpline telephone advice line, run by the Canadian Cancer Society
  • free transdermal nicotine replacement therapy for 6 weeks Smokers of 10 cigarettes per day or more receive 4 weeks of nicoderm 21mg/day, 1 week of 14mg/day and 1 week of 7mg/day Smokers of less than 10 cigarettes per day receive 4 weeks of nicoderm 14mg/day and 2 weeks of 7mg/day
Other Names:
  • nicoderm
  • transdermal nicotine replacement therapy
  • nicotine replacement patch
  • No Intervention: Control
    No intervention. Patients will receive standard of care.
  • Experimental: Smoking cessation program
    Receives smoking cessation program
    Intervention: Other: Smoking cessation program
Lee SM, Landry J, Jones PM, Buhrmann O, Morley-Forster P. Long-term quit rates after a perioperative smoking cessation randomized controlled trial. Anesth Analg. 2015 Mar;120(3):582-7. doi: 10.1213/ANE.0000000000000555.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Same as current
August 2013
May 2012   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • smokers (defined as those that smoke at least 2 cigarettes per day and have smoked within the last 7 days)
  • over age 18
  • presenting to preadmission clinic at St. Joseph's Health Care at least 3 weeks prior to scheduled date of surgery

Exclusion Criteria:

  • less than age 18
  • poor proficiency in English language
  • pregnant
  • breastfeeding
  • unable to consent due to severe mental illness or dementia
  • actively participating in another smoking cessation trial
Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
17342 ( Other Identifier: UWO Health Sciences Research Ethics Board )
Not Provided
Not Provided
Philip Jones, Lawson Health Research Institute
Lawson Health Research Institute
University of Western Ontario, Canada
Principal Investigator: Philip Jones, MD, FRCPC University of Western Ontario, Canada
Lawson Health Research Institute
August 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP