Résumé des données probantes
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J'ai compris, masquez ceciBehavioural treatments to stop smoking before surgery reduce complications after surgery
Thomsen T, Villebro N, Moller AM Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2014;3:CD002294.
Review question
Does helping people to quit smoking before they have elective surgery result in fewer complications after surgery?
Background
People who smoke are more likely to have complications after surgery. Several treatments help people to stop smoking, including written materials, brief advice, counselling, and medications. Providing support to stop smoking before elective surgery may reduce complications after surgery.
How the review was done
The researchers did a systematic review, searching for studies published up to January 2014. They found 13 randomized controlled trials with 1210 people. The trials included:
- people of any age who were having elective surgery, and
- support to stop smoking in the form of brief or intensive behavioural treatments or medications that started at least 48 hours before surgery.
What the researchers found
There were too few studies on medications to combine the results.
Behavioural treatments were brief or intensive (that is, included weekly counselling sessions for 4 to 8 weeks).
Compared with the control group:
- about 27 fewer people out of 100 had complications 4 weeks after surgery in the intensive treatment group, but there was no difference in complications with brief treatment;
- about 46 more people out of 100 in the intensive treatment group and about 12 more out of 100 in the brief treatment group had stopped smoking at the time of surgery; and
- about 21 more people out of 100 in the intensive treatment group had stopped smoking after 12 months, but there was no difference in stopping smoking with brief treatment.
Conclusion
Helping people to stop smoking with intensive behavioural treatment that starts before surgery reduces complications after surgery and increases the number of people who stop smoking at the time of surgery and after 1 year.
Intensive or brief behavioural treatment vs control to stop smoking before elective surgery
| Outcomes | Type of treatment | Number of trials (people) | Rate of events with behavioural treatment | Rate of events with control | Absolute effect of behavioural treatment |
| Postoperative complications at 4 weeks | Intensive | 2 trials (210 people | 19% | 46% | About 27 fewer people out of 100 had complications |
|
| Brief | 4 trials (493 people | 28% | 31% | No difference in effect |
| Stopped smoking at time of surgery | Intensive | 2 trials (210 people) | 51% | 5% | About 46 more people out of 100 stopped smoking |
|
| Brief | 7 trials (1,411 people) | 50% | 38% | About 12 more people out of 100 stopped smoking |
| Stopped smoking at 1 year | Intensive | 2 trials (209 people) | 31% | 10% | About 21 more people out of 100 stopped smoking |
|
| Brief | 2 trials (341 people) | 17% | 16% | No difference in effect* |
Related Topics
Glossaire
A group that receives either no treatment or a standard treatment.
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
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