Preoperative smoking cessation counseling activities of anesthesiologists: a cross-sectional study

Abstract

BackgroundSmokers undergoing surgery are at a higher risk of complications than non-smokers. Preoperative evaluation by an anesthesiologist could provide an excellent opportunity to promote smoking cessation. Previous surveys of anesthesiologists have found that self-reported smoking cessation counseling rates have room for improvement, but no study has surveyed patients to obtain more accurate estimates.MethodsA single-center study was conducted from January 2010 to June 2010 in a tertiary teaching hospital. A telephone survey was conducted, which included all adult cigarette smokers who visited the preoperative anesthesia clinic. The survey recorded anesthesiologist-delivered interventions to help patients quit smoking before surgery. At the end of the study period, the self-reported smoking cessation counseling of the anesthesiologist was evaluated by questionnaire.ResultsOne thousand one hundred and sixty-five patients were evaluated, of which 217 were current smokers with a median pack-year of 15 (interquartile range 5.25–30.00) and 34% were scheduled to undergo major surgery. With regard to preoperative interventions, most anesthesiologists (85%) asked about smoking status, although only 31% advised patients about the health risks of smoking and 23% advised patients to quit before surgery. Provision of assistance to help patients quit was provided in 3% of cases. By contrast, 75% of anesthesiologists stated that they frequently or almost always advised patients about the health risks of smoking.ConclusionsThis study shows significant discrepancies between direct patient surveys of preoperative smoking cessation counseling activities by anesthesiologists and the self-reported perceptions of the anesthesiologists. Future studies are urgently needed to evaluate the provision of educational materials and other interventions to improve smoking cessation counseling rates among anesthesiologists and to narrow these discrepancies.

Smoking and pulmonary complications: respiratory prehabilitation

“…There is need for education of health care professionals and young physicians to promote smoking cessation before the operation in the in-patient management (24). There is strong evidence about the usefulness of the smoking cessation program given the reduction of smoking-related complications, and stopping tobacco usage needs to be a part of preoperative rehabilitation (24). Smoking cessation training should be included in the education of medical students and prevention guidelines (19).…”

The Addition of Tick-boxes Related to Tobacco Cessation Improves Smoking-related Documentation in the Anaesthesia Chart

“…For example, the majority of elective assessments occurred on the day of surgery when time barriers may have been a factor preventing anaesthetists engaging with tobacco discussions. It is possible that higher levels of preoperative smoking cessation counselling could occur in a preoperative clinic setting that takes place some days or weeks before surgery 12 when the clinical environment may be better for patients and anaesthetists for such discussions.…”

Preoperative patient preparation in enhanced recovery pathways

“…recorded anesthesiologist-delivered interventions to help quit smoking before surgery. [ 15 ] Studies showed intensive smoking and alcohol cessation intervention 6–8 weeks before elective surgery could reduce postoperative morbidity by about 50%. [ 16 ] Postoperative smoking-cessation in elective surgery and after fractured surgery might likewise reduce complications.…”