Stop Smoking Before Surgery
- 2012 systematic review concludes smokers who quit before surgery have fewer complicationsThe objective of a large 2012 review was to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications. Based on an analysis of 25 studies, it reports that smokers who quit more than four weeks before surgery had lower risk of respiratory and wound-healing complications than current smokers. Quitting less than four weeks before surgery did not appear to increase or decrease postoperative respiratory complications.Wong J, Lam DP, Abrishami A, Chan M, & Chung F. Short term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Canadian Journal of Anesthesia 2012; 59: 268-279.
- 2012 systematic review concludes smoking delays healing in surgical patients
The objective of a large 2012 systematic review was to clarify how smoking and nicotine affects wound healing processes and to establish if smoking cessation and nicotine replacement therapy reverse the mechanisms involved. In total, 177 articles were included. The author concludes that smoking has a prolonged effect on inﬂammatory and reparative cell functions leading to delayed healing and complications. Smoking cessation restores the tissue microenvironment rapidly and the inﬂammatory cellular functions within four weeks.
Sorensen LT. Wound healing and infection in surgery. The pathophysiological impact of smoking, smoking cessation and nicotine replacement therapy. Annals of Surgery 2012; 255: 1069-1079.
- 2012 systematic review demonstrates cessation interventions are effective for surgical patients
The objective of the review was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Eight random controlled trials were included. The analysis demonstrates both intensive and brief intervention signiﬁcantly increase smoking cessation at the time of surgery. Interventions that begin four to eight weeks before surgery, include weekly counseling, and use nicotine replacement therapy are more likely to have an impact on long-term smoking cessation.
Thomsen T, Villebro N, & Møller AM. Interventions for preoperative smoking cessation. Cochrane Database of Systematic Reviews 2010; Issue 7. Art. No.: CD002294. DOI: 10.1002/14651858.CD002294.pub3.
The surgical outcomes of current smokers and never smokers were examined in a large US cohort comparison involving a sample of 520,795 non-cardiac surgical patients. The researchers found that smoking was associated with a 40% greater chance of 30-day mortality and a 30-100% greater chance of major morbidity including surgical site infection, pneumonia, unplanned intubation and septic shock.
Turan A, Mascha EJ, Roberman D, et al. Smoking and perioperative outcomes. Anesthesiology 2011; 114: 837-46.
In a large nationally representative longitudinal study of 5,498 patients conducted in the US, researchers found that undergoing major surgery approximately doubled the chances that a smoker would quit.
Shi Y, & Warner DO. Surgery as a teachable moment for smoking cessation. Anesthesiology 2010; 112(1):102-7.
- 2011 study demonstrates that quitting shortly before surgery is safeThe 2011 study demonstrates concerns that stopping smoking shortly before surgery (less than eight weeks) may increase postoperative pulmonary complications are unsubstantiated. Although it may take several weeks to derive pulmonary benefits from quitting, clinicians are advised that “any time is a good time” to encourage pre-surgical patients to quit smoking.Shi Y & Warner DO. Brief preoperative smoking abstinence: Is there a dilemma? Anesthesia and Analgesia 2011; 113:1348 -1351.