Prospective Pilot Study of Smoking Cessation in Patients Undergoing Urologic Surgery

OBJECTIVE To evaluate whether preoperative smoking cessation counseling by urologists using the Ask, Advise, and Refer approach was effective in producing abstinence in patients undergoing urologic surgery. METHODS Smokers who were scheduled for inpatient urologic surgery were prospectively enrolled. Smoking cessation counseling consisted of an Ask, Advise, Refer approach. Validated smoking questionnaires were used to evaluate smoking cessation. The expired carbon monoxide and urine cotinine levels were measured to biochemically confirm short- and long-term smoking abstinence, respectively. RESULTS A total of 38 patients were enrolled in the present study. A significant majority (76%) expressed a willingness to quit smoking long-term at enrollment. On the day of surgery, 9 (28%) of 32 patients reported having quit smoking. However, only 4 (13%) of 32 patients had biochemical confirmation of smoking cessation (negative carbon monoxide and urine cotinine). Similarly, at the first postoperative visit, 8 (29%) of 28 patients reported having quit smoking. However, only 4 (14%) of the 28 patients had biochemical confirmation of smoking cessation (negative carbon monoxide and urine cotinine levels). Despite these results, 89% of the patients continued to express their interest in smoking cessation. CONCLUSION The preliminary results of the present pilot study have indicated that the short-term perioperative smoking cessation rates are modest at best. Alternative or supplemental modalities might be necessary to achieve better results and the ultimate goal of long-term smoking abstinence. UROLOGY 80: 104-109, 2012. Published by Elsevier Inc.