564 Tackling tobacco dependency in surgical patients

Abstract

Abstract Aims Smoking is associated with an increased risk of developing post-operative complications and is a risk factor for abscess development. We aimed to audit our performance in delivering very brief advice (VBA) to surgical patients, and establish a smoking cessation pathway to promote smoking cessation particularly within elective and ambulatory care patients. Methods A retrospective audit was undertaken to identify whether smoking status was documented for all surgical inpatients on admission over a 24 hour period, and those attending the surgical ambulatory care unit with an abscess over a 3 week period. Data was collected on whether very brief advice and referral to smoking cessation service or nicotine replacement therapy was offered. Results In total, 36 inpatients were identified. 4 reported smoking (11.1%), 26 (72.2%) reported no smoking and 6 had no documentation (16.7%). Of those identified as smokers, 50% had documented VBA and 75% were offered NRT. Of the 51 ambulatory patients attending with abscesses, 13 (25.4%) reported smoking, 10 (19.6%) reported no smoking and 28 had no documented smoking status (54.5%). Only 1/13 had VBA documented (7.7%) Conclusions Smoking status is poorly documented in surgical patients presenting to ambulatory care in particular, and there is a high rate of smoking in patients presenting with abscesses. Ambulatory care represents a good opportunity to deliver VBA and direct patients to smoking cessation services. A combined effort between the surgical department and the tobacco dependency service that is present in many hospitals represents a good opportunity to advocate for smoking cessation, primarily in pre operative assessment clinic or surgical ambulatory care.