Temporary abstinence from smoking prior to surgery reduces harm to smokers

Abstract

Almost all smokers accept that smoking is harmful and they would benefit their health by stopping, but continue smoking despite this (1). Interventions by clinicians can encourage and help many of these smokers to try to stop, but only a minority will try and few will succeed (2). Some smokers suspend their smoking if there is a good reason. For example, nearly half of all pregnant women smokers stop smoking on becoming pregnant (3,4), although most resume smoking after the birth of their baby (5). The perioperative period carries risks for smokers that are ameliorated by stopping smoking during that time. It is time to give smokers facing surgery the message that stopping smoking temporarily would reduce their surgical risk, even if they do not want to stop permanently. The English Department of Health is planning such a programme and an experts' conference in France in 2005 recommended perioperative smoking cessation (3). What are the perioperative risks facing smokers, how are these reduced by stopping and what actions should health professionals take?