The goal of this pilot study of a clinical trial is to learn about the acceptability and feasibility of a virtual smoking cessation program in both the perioperative and fracture clinic settings. The main questions this study aims to answer are:

• The number of people that participate in the virtual smoking cessation program
• The acceptability of the number, length, content, and delivery of the email messages provided by the program.

Participants will be asked to subscribe to our virtual intervention which will include:

• A smoking cessation e-learning module component to provide education on the risks of smoking in the surgical or fracture clinic setting, and
• An emailing program component that will provide tailored email messages over a 30-45 day period depending on a patient's Fagerstrom test for nicotine dependence score and motivation to quit smoking.

Researchers will also compare the virtual smoking cessation program to standard care to see if there are any differences shown between both groups in the Fagerstrom test for nicotine dependence scores, number of cigarettes smoked, number of quit attempts, complication rates, and re-admission rates at the 7 day and 30 day time points.

Smoking is the most preventable cause of disease and premature death in Canada. In this pilot study our aim is to determine whether a virtual perioperative program, using automated emails, for smoking cessation is feasible and acceptable for increasing abstinence from smoking, compared to the usual care in patients undergoing surgery or with an acute traumatic fracture. Patients that present to the preoperative clinic or fracture clinic will be recruited for this trial. This feasibility study will be followed by the proposed randomized control trial to identify whether our planned study procedures are acceptable to surgical patients.

Both components of the virtual smoking cessation program (Smoking cessation e-learning modules and Virtual Program Evaluation) will be more personalized to the patient as the patient's nicotine dependence will determine the tailored information that will be provided in the e-learning module and the email messages. Study procedures and components of the virtual smoking cessation program will be modified for clinical use and future research based on the feedback from this pilot study.

Inclusion Criteria:

• 18+ years of age

• Daily or non-daily smoker

• Self-reported smokers who have smoked cigarettes within the past 30 days

• Must be a patient at Toronto Western Hospital or Women's College Hospital who is:

  • Scheduled for an elective surgical procedure that will occur at least 48 hours after recruitment OR
  • Visiting the fracture clinic (UHN) within and including 14 days from the initial date of injury or operation

• Must have a working e-mail address

Exclusion Criteria:

• Patients who have already quit smoking for more than 30 days,
• Patients who cannot read and understand English,
• Patients who have any form of cognitive impairment,
• Patients who do not have a telephone (for follow-up).
• Currently on pharmacological therapy for smoking cessation
• Drug or alcohol abuse or dependence within the past year