I am
heartfoundation.org.au|Helpline 13 11 12

Reducing cardiovascular risk through smoking cessation before elective surgery. A randomized control trial of mailed nicotine replacement therapy (NRT) and behavioural support and relapse-prevention

Dr Ashley Webb, Institution: Peninsula Health

2018 Vanguard Grant

Years funded: 2019-2020


Over 20000 Australians die each year from smoking. Such deaths are cardiovascular related in almost 40%. Even having a few cigarettes a day doubles risks of a heart attack. Quitting sharply reduces risks within a year or two, and is the best thing you can do for your heart.

Each year, large numbers of smokers have planned (elective) surgery for both vascular and non-vascular reasons. Promising evidence shows that offers of quit-help are particularly effective at this time in encouraging permanent quitting.

This will be the first study to evaluate the effect of a tailored quit intervention for all smokers (light and heavy) having elective surgery. The intervention will be offered weeks/months before surgery when the smoker is first put on the waiting list, as this gives more time for quitting and gets hearts and lungs in better shape for surgery. The intervention will be fast-acting Nicotine Replacement Therapy (NRT) lozengers, plus patches (for heavier smokers), and the tailored supply will be posted to acceptors of the offer. The telephone Quitline will provide extra support while quitting.

According to our existing data, relapse to daily smoking after hospitalisation for surgery occurs in 50% of newly abstinent smokers. This will also be the first study to evaluate a relapse prevention strategy for new quitters after having surgery. The relapse kit “Open in case of smoking emergency” will contain advice, phone numbers and fast-acting NRT. The use and effectiveness of the kit in protecting new abstinence will be studied 3-months after surgery.

This study builds on previous work by us that mailed NRT before planned surgery is feasible and increases quitting. By including all smokers, tailored NRT dosing, and a relapse kit, we hope to offer an effective low-cost intervention that any health service could adopt for the many smokers who have surgery. If more Australians give up smoking for good, heart attacks, blocked blood vessels and strokes will be prevented.

You might also be interested in

Research Directory

Research Directory

A program of research to improve ACCESS to cardiovascular care

A program of research to improve ACCESS to cardiovascular care

Professor Robyn Clark, Institution: Flinders University...

Altering the rehabilitation environment to improve stroke survivor activity (AREISSA)

Altering the rehabilitation environment to improve stroke survivor activity (AREISSA)

Assistant Professor Neil Spratt, Institution: The University of Newcastle...

Constructing Aboriginal health: a review of cardiovascular research, 1933-2014

Constructing Aboriginal health: a review of cardiovascular research, 1933-2014

Ms Joanne Luke, Institution: University of Melbourne...

Exercise and brain volume loss after stroke

Exercise and brain volume loss after stroke

Professor Amy Brodtmann, Institution: Florey Institute of Neuroscience and Mental Health...

Growing healthy hearts - how passive smoke exposure and elevated blood pressure early in life impacts adult cardiovascular health

Growing healthy hearts - how passive smoke exposure and elevated blood pressure early in life impacts adult cardiovascular health

Growing healthy hearts - how passive smoke exposure and elevated blood pressure early in life impacts adult cardiovascular health

Dr Costan Magnussen, Institution: University of Tasmania...

Lipid disorders in patients at high cardiovascular disease risk

Lipid disorders in patients at high cardiovascular disease risk

Dr Esther Ooi, Institution: University of Western Australia...

Promoting active, healthy lifestyles among women at key life stages

Promoting active, healthy lifestyles among women at key life stages

Associate Professor Verity Cleland, Institution: University of Tasmania...

Reducing population salt consumption in Victoria

Reducing population salt consumption in Victoria

Reducing population salt consumption in Victoria

Professor Bruce Neal, Institution: University of New South Wales...

Starting early – Increasing young children’s physical activity

Starting early – Increasing young children’s physical activity

Associate Professor Hayley Christian, Institution: University of Western Australia...

Heart Age Calculator

Heart Age Calculator

Heart Age Calculator

Could you be at risk of heart disease? Get your estimated heart age now....

Heart Health Check Toolkit

Heart Health Check Toolkit

Environment, climate change and heart health

Environment, climate change and heart health

Environment, climate change and heart health

Information on how air pollution, heatwaves and bushfires can impact heart health, and what you can do to look after yourself. ...

Baking recipes

Baking recipes

Baking recipes

Find heart healthy baking recipes ...

Order patient resources online

Order patient resources online

Search and order from our range of printed patient resources online. ...

Clinical resources: Coronary heart disease and mental health

Clinical resources: Coronary heart disease and mental health

The prevalence of depression is high in patients with coronary heart disease (CHD)....

Hazelnut maple granola clusters

Hazelnut maple granola clusters

Hazelnut maple granola clusters

30 minutes

Being a carer for a heart attack patient

Being a carer for a heart attack patient

Being a carer for a heart attack patient

Your role as a carer for a heart attack patient is an important one – explore some useful things to know....

What is a heart attack?

What is a heart attack?

What is a heart attack?

The most common cause of a heart attack is coronary heart disease....

WEBINAR | Heart Health Checks: the critical role of the practice nurse

WEBINAR | Heart Health Checks: the critical role of the practice nurse

WEBINAR | Heart Health Checks: the critical role of the practice nurse

This webinar discusses the role of practice nurses in conducting heart health checks...

Feelings and emotions after a heart attack

Feelings and emotions after a heart attack

Feelings and emotions after a heart attack

This is a guide to how you might be feeling after a heart attack. ...

Meditation helped Grant recover from his heart attack

Meditation helped Grant recover from his heart attack

Meditation helped Grant recover from his heart attack

Thankfully for Grant Byrne, a lifelong Led Zeppelin fan, some quick thinking helped him avoid a stairway to heaven. Read Grant’s heart attack story now. ...

Heart medicines – Frequently asked questions

Heart medicines – Frequently asked questions

Heart medicines – Frequently asked questions

Find answers below to frequently asked questions about heart medicines. ...

Overcoming uncertainty: Bianca Beetham’s heart story

Overcoming uncertainty: Bianca Beetham’s heart story

Overcoming uncertainty: Bianca Beetham’s heart story

Bianca Beetham is 24 years old and lives in Sydney. She is currently waiting for her first open-heart surgery after being diagnosed with hypertrophic cardiomyopathy five years ago....

Atrial fibrillation resources for patients

Atrial fibrillation resources for patients

Automated Implantable Cardioverter Defibrillator (ICD or AICD)

Automated Implantable Cardioverter Defibrillator (ICD or AICD)

This is a device inserted into your chest to return abnormal heart rhythms to normal using electrical impulses. ...

For professionals: Guidelines for acute rheumatic fever and rheumatic heart disease

For professionals: Guidelines for acute rheumatic fever and rheumatic heart disease

Australian  guidelines  for  prevention, diagnosis and  management of  acute  rheumatic  fever and  rheumatic  heart  disease ...

Driving Best Practice CVD Prevention in a Post-COVID World

Driving Best Practice CVD Prevention in a Post-COVID World

Driving Best Practice CVD Prevention in a Post-COVID World

Asian (Chilli, soy and sesame) dressing

Asian (Chilli, soy and sesame) dressing

Asian (Chilli, soy and sesame) dressing

10 minutes
Serves 12 (1 tablespoon)

Chest x-ray for heart disease

Chest x-ray for heart disease

Chest x-ray for heart disease

This test can help your doctor determine if there is anything wrong with your heart....

Q&A with Dr Louise Segan

Q&A with Dr Louise Segan

Q&A with Dr Louise Segan

Optimal treatment of atrial fibrillation in people with cardiac dysfunction and scarring of the heart ...

Permanent Pacemaker (PPM)

Permanent Pacemaker (PPM)

A small, battery-powered device that is fitted under the skin of your upper chest....

Australian Heart Maps

Australian Heart Maps

Australian Heart Maps

Our Heart Maps allow you to take a closer look at heart disease indicators across Australia....

Cardiac rehabilitation resources for healthcare providers

Cardiac rehabilitation resources for healthcare providers

Useful cardiac rehabilitation resources for health professionals....

WEBINAR | Navigating the latest updates on CVD prevention

WEBINAR | Navigating the latest updates on CVD prevention

WEBINAR | Pressure rising: Clinical controversies and updates in hypertension

WEBINAR | Pressure rising: Clinical controversies and updates in hypertension

WEBINAR | Pressure rising: Clinical controversies and updates in hypertension

Women's heart stories

Women's heart stories

Women's heart stories

Women's stories from around Australia...

How we work

How we work

How we work

One Heart, One Team...

What is cardiac rehab?

What is cardiac rehab?

What is cardiac rehab?

Cardiac rehab is proven to keep you out of hospital and reduce your risk of death from heart conditions....

Support for young adults: Online events

Support for young adults: Online events

Support for young adults: Online events

Check back in for the latest updates on Supporting Young Heart events...