LAUSR

INTRODUCTION Smoking cessation, both pre-and postoperatively is important to reduce complications associated with surgery. Identifying feasible and effective means of alerting the patient before surgery of the importance of perioperative smoking cessation is a challenge to health care systems. MATERIAL AND METHODS A randomized registry-based trial using the web-version of the Swedish national quality register for gynecological surgery, GynOp was performed (ClinicalTrials.gov NCT03942146). Current smokers scheduled for gynecological surgery were randomly assigned before surgery to: (Group 1, control group, no specific information, Group 2, web-based written information, Group 3, information to doctor that the woman was a smoker and should be recommended smoking cessation, or Group 4, a combination of group 2 and 3). Perioperative smoking habits were evaluated in a postoperative questionnaire 2 months after surgery. The treatment effect was estimated to be a 15 % reduction of smokers at time of surgery. Thus, 94 women in each group were required, in total 376 women, using a one-sided test with an alfa level of 0.001 and a statistical power of 80%." RESULTS Participants (n = 1427) were recruited between November 5, 2015, and December 6, 2017. 1137 smokers responded to the follow-up questionnaire (80%) and 486 women declined participation leaving 651 women eligible for analysis. Women who received both web-based information prior to surgery and information from a doctor reported smoking cessation more often from 1-3 weeks preoperatively (Odds ratio, 95% confidence interval 1.8 [1.0-3.3]) and 1-3 weeks after surgery (1.9 [1.1-3.3]) compared to the control group who received no specific information. CONCLUSIONS A combination of written information in the health declaration and a recommendation from a doctor regarding smoking cessation may be associated with higher odds of smoking cessation at 1-3 weeks pre- and post-operatively.