Please select the eligibility criteria that correspond to the clinical trial below.
Title: Monitoring of Exhaled Carbon Monoxide to Promote Pre-operative Smoking Cessation
Brief Summary: Smoking causes 90% of all lung cancer deaths among men and 80% of lung cancer deaths in women. Surgery is a great opportunity to help patients quit smoking. Smokers are at increased risk for heart, lung, and wound complications around the time of surgery. Even a brief abstinence from smoking can produce benefits. Surgery can also motivate smokers to quit spontaneously. If the investigators can take advantage of this great opportunity, they may be able to help many smokers quit using simple means. However, currently most smokers continue to smoke cigarette on the morning before surgery, as shown by the measurement of exhaled carbon monoxide (CO) on the morning of surgery. CO is one of the many poisons in cigarette smoke. It only stays in the body for a few hours. By asking smokers to blow into a small machine, the investigators can test the CO level in the smokers' body and thus know if they have just smoked within the past few hours. The goal of this study is to determine the role of carbon monoxide monitoring as a means to decrease cigarette smoking before surgery. The investigators will identify a group of smokers who are scheduled for surgery and invite them to participate. One or two days before surgery, half of the patients will receive a brief advice about quit smoking. The other half of patients will be told that their CO will be checked before surgery, in addition to the brief advice. On the morning of surgery, the investigators will then check their CO level to determine if they have followed the advice. In order to have a better understanding about the factors influencing patients' intent to quit smoking, the investigators will ask all study participants to fill out a questionnaire. The questionnaire is constructed according to behavioral theories which provide good framework for studying people's intent and behavior. If the investigators are successful, they will determine how much of an impact the message of CO testing has on smoking before surgery. The investigators will also gain insights into facilitators and barriers to smoking cessation around the time of surgery. The brief intervention evaluated in this study has potential to be disseminated and to promote the long term health of surgical patients.


Options:
A: Inclusion Criteria:

1. Participants must report smoking at least 5 cigarettes per day for the previous 6 months AND sometimes smoke at least 10 cigarettes in one day.
2. Participants must want to quit smoking and be ready to make a quit attempt within the next 30 days.
3. Participants must plan to remain in the intervention catchment area for at least 8 months.
4. Age \>18 years. Nicotine patches are not currently approved by FDA for those under age 18.
5. Participants must be willing to attend and provide data at the 8 study visits, including an assessment visit at which a blood sample will be drawn, 6 group treatment sessions, respond to follow-up telephone calls, and a 6-month follow-up visit.
6. Participants must be able to read and write in English.
7. Nicotine is known to be harmful to the developing human fetus at the recommended therapeutic dose. For this reason women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the standard duration of transdermal nicotine therapy (10 weeks). Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, the patient should inform the treating clinician immediately.
8. Ability to understand and the willingness to sign a written informed consent document

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Exclusion Criteria:

1. A history of severe allergic reaction while using a nicotine patch.
2. Currently using a drug/medicine as an aid to smoking cessation (e.g. Zyban, Chantix, nicotine replacement).
3. Currently pregnant, trying to get pregnant, or nursing, because nicotine is known to be harmful to the developing human fetus at the recommended therapeutic dose.
4. Had a heart attack, stroke, continuing arrhythmias or angina (chest pains) or abnormal electrocardiogram within the past 4 weeks.
5. Uncontrolled serious mental illness or substance abuse.
6. Uses non-cigarette tobacco products and does not plan to quit all tobacco.

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B: Inclusion Criteria:

* Current daily smoker with more or equal to 10 cigarettes per day for at least 1 year
* Age between 40 and 70 years

Exclusion Criteria:

* Prevalent CVD at baseline, defined as a medical diagnosis or self-report of coronary heart disease, stroke or transient ischemic attack, peripheral arterial disease, carotid artery disease, congestive heart failure, or having a pacemaker.
* Unstable life-threatening or severe medical conditions (major arrhythmia, cancer,...)
* Current psychiatric disease
* Current substance abuse (cannabis, other drugs, alcohol abuse)
* Current use of pharmacological agent to quit smoking
* Current participation in another clinical trial
* Plan to move out of the French part of Switzerland in the following year
* Recent carotid ultrasound (\< 1 year) to assess subclinical CVD
* Language barrier (not fluent with French)
* Potential difficulty to obtain good imaging of the carotid by ultrasound: past radiotherapy or major surgery of the neck
C: Inclusion Criteria:

1. Patients ≥ 18 yrs. scheduled for elective non-cardiac surgery at Mayo Clinic Rochester;
2. Current smoking, defined as \> 100 cigarettes lifetime consumption and self-report of smoking every day.

Exclusion Criteria:

1. An inability to understand consent procedures;
2. Inability to complete a written questionnaire.
D: Inclusion Criteria:

* Aged 20-70 years
* Smoking more than 10 cigarettes daily

Exclusion Criteria:

* Aged under 20 years or over 70 years
* Smoking less than 10 cigarettes daily
* History of major depression and other psychiatric conditions, dementias and serious or terminal illness (cancers etc.).
* Patients on warfarin would be excluded due to interactions between warfarin and varenicline as varenicline will be used as the modern treatment of choice for smoking cessation.

Patients who did not wish to have a genetic test would be referred to the practice nurse for smoking cessation.

Answer: C