Printed quit-pack sent to surgical patients at time of waiting list placement improved perioperative quitting

BACKGROUND: This study aimed to measure the effects of sending a smoking cessation 'quit-pack' to all patients placed on the elective surgical waiting list.

METHOD: Questionnaire-based study before intervention (mid-2011, 177 patients) and after (2012/13, 170 patients) conducted on day of surgery. All were identified as adult smokers at time of waiting list placement at an outer metropolitan Melbourne public hospital. The intervention was a quit-pack consisting of educational brochure containing cessation advice and focused on perioperative risks of smoking, together with Quitline referral form and reply-paid envelope. The primary outcome measure was proportion of smokers who quit on waiting list for ≥1 month before surgery, considered a clinically meaningful duration to reduce surgical complications.

RESULTS: An 8.6% improvement in waiting list smokers achieving the target ≥1 month abstinence at day of surgery (P = 0.03). The number needed to treat of 12 (95% confidence interval 6-240) meant 12 smokers receiving intervention would create one additional episode of clinically meaningful quitting on wait list.

CONCLUSION: Smoking cessation outcomes before elective surgery are significantly improved by systematic application of a printed intervention delivered at time of wait list placement that encourages and supports perioperative quitting.