Blog by Jack D Madden, MBBS
It is well established that smokers are at increased risk of pulmonary, cardiovascular and wound-related complications following surgery. As the scope of anaesthesia continues to expand beyond the operating theatre, anaesthetists should adopt a key role in the promotion of smoking cessation.
Wong and Chung summarise the evidence and common barriers to perioperative smoking cessation, and encourage a shift in culture that maximises the opportunities for education and referral in the perioperative setting. Lack of training, time and resources, as well as misconceptions regarding the safety of smoking cessation immediately prior to surgery are potential barriers to overcome.
Smoking cessation programs that begin at the preoperative visit, during the surgical admission or in the postoperative period have all been shown to improve abstinence rates in smokers. One randomised controlled trial showed that even brief advice 1-3 weeks prior to surgery in conjunction with nicotine replacement therapy and a referral to a smoking “quit line” increased long term abstinence from smoking at 12 months.
The authors reiterate that every anaesthetist has a role in the promotion of smoking cessation. Empowering patients with structured advice and pharmacological options for smoking cessation should carry the same importance as optimising medical conditions during the preanaesthetic visit. “The time to act is now.”