Thoracic Surgeons’ Beliefs and Practices on Smoking Cessation Before Lung Resection

Marrufo, Angelica S.; Kozower, Benjamin D.; Tancredi, Daniel J.; Nuño, Miriam A; Cooke, David T.; Pollock, Brad H.; Romano, Patrick S.; Brown, Lisa M.

doi:10.1016/j.athoracsur.2018.11.055

Cited by 16 publications

(13 citation statements)

References 22 publications

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“…Attitudes of thoracic surgeons are inconsistent, with no consensus on standard practice for pre-operative smoking cessation. A survey of US thoracic surgeons demonstrated that most (60%) do not require a patient to cease smoking prior to surgery, with those who do mandate cessation divided on the recommended duration of the smoking abstinence period [ 21 ]. Most US surgeons do not routinely refer to smoking cessation programs or prescribe nicotine replacement therapy prior to surgery [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…A survey of US thoracic surgeons demonstrated that most (60%) do not require a patient to cease smoking prior to surgery, with those who do mandate cessation divided on the recommended duration of the smoking abstinence period [ 21 ]. Most US surgeons do not routinely refer to smoking cessation programs or prescribe nicotine replacement therapy prior to surgery [ 21 ]. although nicotine dependence treatment is known to be highly effective in effecting short-term cessation amongst cancer patients [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of smoking status and chronic obstructive pulmonary disease on pulmonary complications post lung cancer surgery

et al. 2022

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Introduction Smoking and chronic obstructive pulmonary disease (COPD) are associated with an increased risk of post-operative pulmonary complications (PPCs) following lung cancer resection. It remains unclear whether smoking cessation reduces this risk. Methods Retrospective review of a large, prospectively collected database of over 1000 consecutive resections for lung cancer in a quaternary lung cancer centre over a 23-year period. Results One thousand and thirteen patients underwent curative-intent lobectomy or pneumonectomy between 1995 and 2018. Three hundred and sixty-two patients (36%) were ex-smokers, 314 (31%) were current smokers and 111 (11%) were never smokers. A pre-operative diagnosis of COPD was present in 57% of current smokers, 57% of ex-smokers and 20% of never smokers. Just over 25% of patients experienced a PPC. PPCs were more frequent in current smokers compared to never smokers (27% vs 17%, p = 0.036), however, no difference was seen between current and ex-smokers (p = 0.412) or between never and ex-smokers (p = 0.113). Those with a diagnosis of COPD, independent of smoking status, had a higher frequency of both PPCs (65% vs 35%, p<0.01) and overall complications (60% vs 40%, p<0.01) as well as a longer length of hospital stay (10 vs 9 days, p<0.01). Conclusion Smoking and COPD are both associated with a higher rate of PPCs post lung cancer resection. COPD, independent of smoking status, is also associated with an increased overall post-operative complication rate and length of hospital stay. An emphasis on COPD treatment optimisation, rather than smoking cessation in isolation, may help improve post-operative outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of smoking status and chronic obstructive pulmonary disease on pulmonary complications post lung cancer surgery

et al. 2022

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“…The optimization of underlying medical issues (particularly cardiac, pulmonary, renal, and diabetes) is paramount in decreasing the perioperative morbidity of PM. Moreover, current smokers should be encouraged to quit before surgery to decrease the risks of postoperative complications, especially in cases that will involve anatomic lung resections …”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…Moreover, current smokers should be encouraged to quit before surgery to decrease the risks of postoperative complications, especially in cases that will involve anatomic lung resections. 15 An accurate assessment of the patientʼs functional status is also necessary. The ability to climb two flights of stairs generally indicates a high likelihood that the patient will tolerate lung resection up to and including lobectomy.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Surgical management of colorectal lung metastases

Phillips

Hasson

2019

Journal of Surgical Oncology

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Pulmonary metastasectomy for colorectal cancer is an established means of treatment for select patients. This article will highlight the recent evidence published in the literature related to current practices for the surgical management of colorectal lung metastases and propose a diagnostic algorithm for use in clinical practice. It will also discuss controversies related to pulmonary metastasectomy, including the optimal timing of surgery, the extent of lymph node sampling/dissection, and the extent of surgical resection.

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“…Although rates of documenting tobacco use are high in the outpatient setting, rates for assisting or referring patients for treatment are much lower 5 . In a survey of thoracic surgeons, only 9% provided nicotine replacement treatment (NRT) and referred smokers for counseling 6 . It is essential to employ strategies to gather tobacco use information that can be acted upon at the point-of-care to deliver smoking cessation treatment.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of collecting computer-facilitated patient-reported tobacco use, interest, and preferences for smoking cessation in an outpatient thoracic surgery and oncology setting

Nayak¹,

Mazzola²,

Jaklitsch³

et al. 2022

Tob. Induc. Dis.

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INTRODUCTION Effective strategies are needed to facilitate collection of tobacco use information and integrate smoking cessation treatment into the routine care of all high-risk patient populations to improve clinical outcomes. The objective of this study was to establish the feasibility of collecting computer-facilitated patientreported tobacco use, identify patient interest and preferences for smoking cessation in an outpatient thoracic surgery and oncology setting with higher prevalence of tobacco use than the general population. METHODS A brief patient-administered tobacco screening survey was handed out on an iPad in the waiting room of a thoracic surgery and oncology practice setting to sequential patients with varying diagnoses. Tobacco use, household exposure to tobacco, and interest and preferences for smoking cessation treatment were recorded. Descriptive statistics and Pearson's chi-squared test were used for analysis. RESULTS Of the 599 surveys administered, 594 (99%) were completed. Self-reported smoking status included 36.4% (n=218) never smokers, 53.3% (n=319) former smokers, and 10.4% (n=62) current smokers. Among current smokers, 45.2% (n=28) were interested in receiving smoking cessation treatment. Preferences for treatment included: 21.4% (n=6) who wanted Quitline only, 25% (n=7) medication alone, and 53.6% (n=15) combined Quitline plus medication. Current smokers (55.7%, n=34) were more likely to live in households with tobacco exposure compared to those with former (11.4%, n=36) or never smokers (8.3%, n=18) (p<0.0001). CONCLUSIONS Implementing a computer-facilitated system to screen for current smoking and provide smoking cessation services was feasible in the outpatient thoracic surgery and oncology setting. Almost half of the smokers indicated an interest in receipt of smoking cessation treatment. Household exposure was more frequent among current smokers, therefore routine screening for secondhand smoke exposure from other household members is an important consideration in developing smoking cessation treatment plans to mitigate health risks among vulnerable patient populations.

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Thoracic Surgeons’ Beliefs and Practices on Smoking Cessation Before Lung Resection

Cited by 16 publications

References 22 publications

Impact of smoking status and chronic obstructive pulmonary disease on pulmonary complications post lung cancer surgery

Impact of smoking status and chronic obstructive pulmonary disease on pulmonary complications post lung cancer surgery

Surgical management of colorectal lung metastases

Feasibility of collecting computer-facilitated patient-reported tobacco use, interest, and preferences for smoking cessation in an outpatient thoracic surgery and oncology setting

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