Abstract

Smoking cessation interventions are often ineffective, although negative health effects of smoking are well established. However, evidence suggests that diagnosis of a severe medical condition or a surgical intervention may force people to quit smoking without any counseling. Aim of this study was to determine the smoking cessation rate among patients undergoing lung resection and factors associated with perioperative smoking cessation. All lung resection patients in one thoracic surgery department in 6 years were included. A phone-interview was conducted with all (accessible) patients aged ≥ 16. Wilcoxon rank-sum test, and chi-squared or Fisher exact test were used for statistical analysis. In 6 years 970 patients were operated on; 406 (229 male, 177 female; mean age 56.4 [range 16 to 85] years) were available for the study. At the time of surgery 155 patients (38.2%) were non-smokers, 82 (20.2%) ex-smokers, and 169 (41.6%) current smokers. 56.3% of males and 22.6% of females were smokers (p<0.0001). 145 patients had lung cancer and 261 patients other causes for lung resection, with different smoking distribution in these 2 groups (p<0.0001). Sixty nine patients (40.8%) quit smoking before the operation: 22 due to the planned operation, 23 due to the newly diagnosed disease, and 24 for other reasons. Seventy two patients (42.6%) did not smoke after hospital discharge including 66 (39.1%) also a year later. An additional 40 (23.7%) patients had tried to stop, and 57 (33.7%) continued smoking. The quit rate was higher among lung cancer patients versus others (uncorrected p=0.007), and patients operated through thoracotomy versus VATS (uncorrected p=0.0295); and was not influenced by age, gender or duration of smoking before quitting. Almost 40% of patients undergoing lung resection stopped smoking without special counseling, with very few restarting. Smoking cessation rate was higher among patients with lung cancer and patients operated through thoracotomy.

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