Perioperative Smoking Cessation Interventions

Purpose & Objective: Behavioral interventions in surgical patients are an opportunity to
improve outcomes through decreased complications, with measurable economic impact. Smoking
cessation is one of the most desirable long-term health behaviors for adults with potential
substantial impact on postoperative complications

Study Activity & Population Group: The investigators propose a precommitment contractual
agreement implementing behavioral economic principles at the preoperative appointment for
active tobacco users undergoing an operation and assessing for ability to quit smoking with
testing on the day of surgery, and the durability of cessation over the postoperative course
as measured with urine nicotine testing at follow up appointments. The population of interest
is adults who currently smoke tobacco or vaporized nicotine who are scheduled to undergo a
major operation. The control group is standard of care; prescriptive advice to quit smoking.
The intervention is contract agreement for preoperative cessation.

Data Analysis & Risk Issues: Following informed consent patients will be randomized to
control or intervention groups, baseline urine nicotine tests will be performed in clinic.
Urine nicotine testing will be performed on the day of enrollment, the day of their
operation, and at their one-month follow up appointments. Thirty-day outcomes will be
evaluated by retrospective chart review.

Inclusion Criteria:

- active tobacco use

- preoperative appointment for an operation within 6 weeks

Exclusion Criteria:

- active enrollment in tobacco cessation program