Impact of a Perioperative Smoking and Alcohol Cessation Intervention on Health-related Quality of Life in Patients Undergoing Radical Cystectomy: A Randomised Controlled Trial

The impact of a smoking and alcohol cessation intervention on health-related quality of life (HRQoL) following radical cystectomy (RC) is unclear. This study aimed to evaluate the effect of a 6-wk perioperative smoking and/or alcohol cessation intervention on HRQoL. A secondary objective was to assess the difference in HRQoL between patients with more than two and those with fewer complications. From 2014 to 2018, 104 patients referred to RC who smoked daily or consumed at least three alcohol units per day were enrolled in a multicentre randomised clinical trial. Participants were assigned to a 6-wk intensive smoking and/or alcohol cessation programme or standard care. The smoking cessation programme had five meetings in 6 wk and was based on the principles of motivational interviewing, balanced decision-making, and the transtheoretical model of change. HRQoL was assessed at baseline, and 6 and 12 mo using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and BLM30 questionnaires. Linear regression models were used to analyse the association between intervention, complications, and HRQoL. There were differences in baseline demographic and lifestyle factors between groups. At the end of intervention, 51% of the intervention group and 27% of the control group quit successfully; after 12 mo, 21% and 36%, respectively, were quitters. No significant differences in HRQoL were found between the intervention and control groups. However, patients with more than two complications had significantly lower HRQoL on the QLQ-C30 scale, while no difference was observed on the BLM30 scale. A study limitation is the nonparticipation rate of 53%. The cessation intervention did not impact HRQoL significantly in patients undergoing RC. However, patients with more than two complications experienced reduced HRQoL, highlighting the importance of identifying at-risk patients preoperatively.