Prevalence, trends and outcomes from smoking in elective surgical systems: a secondary analysis of a prospective observational cohort study across 442 hospitals from 29 countries across Europe
Abstract
Summary Background Smoking remains a significant public health issue in Europe, with elective surgery offering a key opportunity for intervention. Knowledge gaps exist around its prevalence and the optimal timing for preoperative cessation to improve outcomes, despite current guidelines recommend smoking cessation up to six weeks prior to surgery. This study aims to address this gap in a large observational prospective cohort study of patients undergoing abdominal surgery across Europe. Methods We performed a pre-planned secondary analysis of a prospective, international cohort study of patients undergoing elective abdominal surgery between January 24, and May 03, 2022. The primary measure was smoking status and secondary measures were prevalence by age, gender, and number of long-term conditions. Multilevel logistic regression was used to explain the relationship between preoperative smoking status on postoperative overall (primary outcome) and major (secondary outcome) complications. Three-level models were constructed with patients nested within hospitals and countries. Findings 16,327 patients from 442 hospitals across 29 countries were included. 3179 patients (19.5%, 95% confidence interval (CI): 18.9%–20.1%) were current smokers, ranging from 8.3% to 31.7% across the included countries. Rates of current smokers were higher in younger patients (18–40 vs 41–60 vs 61–80 vs ≥ 81 years: 26.8% [95% CI: 24.8%–28.9%] vs 25.3% [95% CI: 24.2%–26.4%] vs 15.1% [95% CI:…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 16,327 participants or records.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.