None listed
Conditions
Brief summary
Smoking increases the risk of surgical complications such as wound infections and stopping smoking before surgery can reduce this risk, while smokers who remain quit after surgery are likely to have significant health benefits. We are currently conducting a trial where half the smokers on the wait list or offered free mailed nicotine replacement therapy (NRT) plus quitline support at the time they are wait-listed for surgery. Others get standard care (just a leaflet). We have found uptake of the offer at just 30-40%, and not all offer acceptors use the NRT well. The new trial is to see if a small financial incentive for being quit by surgery works with similar effectiveness as offering NRT before surgery. Offerring no NRT, but a small amount of money, could achieve similar quit results without the cost and complexity of mailing packages of NRT. Smokers (10+) per day are randomized at time of going on the elective surgery wait list to one of four groups: (1) standard care, control group (2) no NRT, just $70 cash if quit by surgery, plus some printed information on how to access own NRT from GP or pharmacy. A change was made to increase the incentive to $140 after the study was commenced (after 454 smokers had been randomised, though most had not had day of surgery data collection due to COVID related delays in elective surgery). The increased incentive applied only to those newly randomised (not the 454 randomised at the $70 level), with a plan to compare the offer uptake (Percentage saying yes to accept the challenge of quiting before surgery and potentially receive the gift) at the $70 level with the $140 level. To prove being quit on day of surgery, smokers claiming to have quit must have <8 parts per million carbon dioxide on breath testing. The study will determine if adding a cash incentive improves quitting, and whether it is a feasible approach for a healthcare service for preoperative smoking reduction
Interventions
A pilot randomised controlled trial (RCT) to evaluate the feasibility and quit-outcomes of small financial incentives (supermarket vouchers) to promote smoking cessation in adult nicotine-dependent smokers (greater or equal to 10/day) wait-listed for future surgery at a Victorian public health service. All eligible smokers will be randomised on wait-list placement to one of 2 groups 1:1 ratio; one is control group, other is intervention arm. Interventions arm is:
Offer of $70 voucher on day of
A pilot randomised controlled trial (RCT) to evaluate the feasibility and quit-outcomes of small financial incentives (supermarket vouchers) to promote smoking cessation in adult nicotine-dependent smokers (greater or equal to 10/day) wait-listed for future surgery at a Victorian public health service. All eligible smokers will be randomised on wait-list placement to one of 2 groups 1:1 ratio; one is control group, other is intervention arm. Interventions arm is: Offer of $70 voucher on day of surgery for proven abstinence, (includes a printed resource outlining ways to access own NRT or other cessation support. This resource was developed specifically for the study) . On 17 May 2021 HREC approval was granted to double the incentive amount to $140 voucher for proven abstinence for newly randomised participants
Sponsors
Dr Ashley Webb
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Smokers of 10 or more cigarettes per day scheduled for an elective operation at the health service. Available for data collection on day of surgery.
Exclusion criteria
Date of surgery known to be within 2-weeks of randomization, not having an operation (eg. minor diagnostic procedure such as endoscopy)
Outcome results
None listed