Preoperative Smoking Cessation Intervention: A Critical Appraisal of the Evidence With Practice Recommendations

Abstract

Smoking is the single most important risk factor in the development of postoperative complications. Daily smoking increases the risk of postoperative complications by a factor of two to four. Smoking cessation preoperatively is beneficial in increasing rates of cessation and therefore reducing the incidence of complications postoperatively. As a result, smoking cessation should be recognized as a core element of care for the preoperative management of the surgical patient. Although the benefits of smoking cessation are well established, as is substantial evidence demonstrating that brief interventions are effective in increasing cessation rates among users, clinicians fail to consistently address the issue of tobacco use or provide smoking cessation interventions. Referral to elective surgical procedures provides an excellent opportunity for primary providers to promote smoking cessation interventions.