禁煙専門機関を介さない周術期外来での禁煙指導のみによる術前禁煙遵守効果：単施設後ろ向き観察研究

Preoperative Smoking-cessation Compliance Following Smoking-cessation Instruction at Our Perioperative Clinic Without Referral/Connection to Smoking Cessation Specialists：A Single-center, Retrospective, Observational Study

要旨

　本研究は，禁煙専門機関を介さない周術期外来での禁煙指導のみによる術前禁煙遵守効果を検討した単施設後ろ向き観察研究である。禁煙指導による術前禁煙遵守率は61％で，1日あたりの喫煙本数は，禁煙遵守群と比較して禁煙非遵守群で有意に多かった。1日あたりの喫煙本数による術前禁煙遵守予測能は，15本をカットオフ値とすると，感度86％，特異度42％であった。周術期外来での禁煙指導のみで過半数が術前禁煙につながった。しかし，1日あたりの喫煙本数が多い症例は，禁煙指導のみでは禁煙を遵守できず，1日あたり15本以上の喫煙本数は，禁煙専門機関へ紹介・接続する指標にできる可能性が示唆された。

　Background：We investigated patients’ compliance with preoperative smoking-cessation instructions（i. e., smoking cessation instruction）at our perioperative clinic.

　Methods：This was a retrospective, single-center, observational study of adult patients who were given a single session of smoking-cessation instruction while visiting our perioperative clinic for scheduled surgery during June 1, 2022 to November 30, 2022. The primary outcome was the relationship between the preoperative smoking-cessation compliance ratio and the smoking-cessation instruction. The study’s secondary outcome was the result of our assessment of differences in the backgrounds of the patients categorized in two groups concerning preoperative smoking cessation：the patients who complied and those who did not.

　Results：We analyzed the cases of the 71 patients who received the smoking-cessation instruction during the study period. The smoking-cessation compliance ratio was 61％（43 patients complied）. The number of cigarettes smoked per day was significantly higher in the group of 28 patients who were unable to quit smoking compared to the compliance group. When we set the cutoff value for compliance at a habit of 15 cigarettes/day prior to the patients’ smoking-cessation instruction, the sensitivity was 86％ for predicting patients’ inability to quit smoking before their surgery.

　Conclusions：The preoperative smoking-cessation instruction provided at our perioperative clinic resulted in the majority of patients achieving preoperative smoking cessation. Our analysis results suggest that（ⅰ）the patients who smoked a higher number of cigarettes per day were unable to quit smoking preoperatively with only smoking-cessation instruction at a perioperative clinic, and（ⅱ）15 cigarettes per day could be used as an indicator for referral/connection to smoking-cessation specialists.