None listed
Conditions
Brief summary
Background: There is plenty of literature available regarding the harmful effects of smoking and the potentially significant positive influence of counselling in the pre-operative period on long-term cessation. There are, however, few studies and guidelines about this in the Australian healthcare system. Hypothesis and aim: Our study hypothesis is that counselling regarding the advantages of quitting smoking in the pre-admission clinic leads to long-term smoking cessation, and we aim to prove this through our study among smokers undergoing elective surgery in the Armadale Health Service. Methods: We will conduct a non-randomised controlled trial among smokers having elective surgery in the Armadale hospital from April 2018 onwards, aiming to recruit 247 smokers who received pre-operative advice to stop smoking, constituting the intervention group, and 247 who underwent surgery prior to April 2018, who did not receive such advice, comprising the control group, by means of telephone interviews. The primary outcome will be the quitting status 6 months after surgery. The data would be analysed using unpaired chi-squared test. This study will be able to detect a significant increase in quit rates after counselling with a type I error of 0.05 and a power of 0.8. Significance: If we are able to show a significant improvement in long-term quit rates after pre-operative counselling, we can create guidelines for our hospital and provide evidence for the Australian health system to make the provision of tailored advice and support to stop smoking during routine pre-anaesthetic check-ups a necessary standard of care. This could be the beginning of an intensive “Quit Smoking Before Surgery” campaign. As a large proportion of smokers would present themselves for surgery at some point in their lives, this might be an easy and highly effective method of reducing the prevalence of this harmful habit in our society.
Interventions
Provision of standardized advice regarding the harmful effects of smoking and the advantages of quitting during the pre-anaesthetic interview by a anaesthetist or nurse.
Patients usually have a half to one hour one-on-one interview in the pre-anaesthetic clinic by either an anaesthetist or a nurse in the Armadale Health Service,, depending upon the complexity of the patient and surgery, During this interview, patients are asked routinely if they smoke or not.
For the purpose of this study, a
Provision of standardized advice regarding the harmful effects of smoking and the advantages of quitting during the pre-anaesthetic interview by a anaesthetist or nurse. Patients usually have a half to one hour one-on-one interview in the pre-anaesthetic clinic by either an anaesthetist or a nurse in the Armadale Health Service,, depending upon the complexity of the patient and surgery, During this interview, patients are asked routinely if they smoke or not. For the purpose of this study, a smoker will be defined as an adult who has smoked cigarettes within the last 28 days and who has smoked at least 100 cigarettes in his or her lifetime. From 1/4/2018 onwards, all smokers will be provided standardized advice regarding the harmful effects of smoking and the advantages of quitting during the pre-anaesthetic interview by a anaesthetist or nurse, whoever is interviewing them. Standardized advice will be defined as 1. Provision of the “Smoking and surgery” leaflet (issued by Department of Health, Government of WA) and simultaneous verbal reinforcement of the information by the pre-admission clinic nurse or anaesthetist; 2. Provision of the Quitline number by the anaesthetist or nurse interviewing the patient; and 3. The provision of prescriptions for nicotine replacement patches if requested by the patient. This whole process should take about 5 minutes of clinic time. Periodic e-mails, once a month, will be sent out to all anaesthetists and nurses working in the clinic to ensure that everyone is aware and motivated to give this advice.
Sponsors
Armadale Health Service
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All current adult smokers undergoing elective surgery at the AHS, who consent to participate, will be included in the study.
Exclusion criteria
Non-smokers, patients less than 18 years of age, those who are pregnant, those with limitations to communicate in English or over the telephone, those who do not have the capacity to give informed consent, and those patients who refuse to participate or are enrolled in any other study will be excluded from this study.
Outcome results
None listed