Does an Intensive Alcohol Cessation Intervention at the Time of Fracture Surgery Induce Smoking Cessation? - The Scand-Ankle Study

Abstract

Background Hazardous alcohol consumption is a risk factor for developing postoperative complications. Other risk factors are smoking, overweight, malnutrition and physical inactivity. Preoperative alcohol and smoking cessation programs have been found effective in reducing postoperative morbidity, but it remains unknown whether these induce a general change of lifestyle. The aim of this study was to investigate whether the gold standard alcohol intervention programme (GSP-A, which is based on the gold standard programme for smoking GSP-S) used in the Scand-Ankle study, affected the non-targeted risk factors; smoking, overweight, malnutrition and physical inactivity.

Method 64 patients with hazardous alcohol consumption who underwent ankle fracture surgery, were randomized to the GSP-A or usual care (control). The groups were compared at baseline and 6 weeks follow-up regarding lifestyle factors. An intention to treat (ITT) and per protocol analysis were performed using non-parametric statistics.

Results The ITT-analysis showed no significant differences between the GSP-A and control group regarding non-targeted risk factors. The per protocol analysis showed that alcohol cessation regardless of study group did not influence non-targeted risk factors.

Conclusion The GSP-A did not affect smoking, overweight, malnutrition and physical inactivity. Thus, a potential effect of the GSP-A on postoperative complications will likely be due to the effect on alcohol intake and not a general change in lifestyle. The findings suggest that multiple lifestyle interventions are required, e.g. combined alcohol and smoking cessation.