Prevalence of and reasons for preoperative tobacco use

Smoking cigarettes has an impact on all aspects of the perioperative anesthetic. It is not known whether patients are typically educated regarding these effects. Eighty-one patients completed a questionnaire concerning smoking behavior in the 24 hours before surgery. Variables measured were smoking history, tobacco addiction, and preoperative education. Chi-square analysis was used. Of 81 participants, 66 (81%) smoked tobacco within 24 hours of surgery. Thirty-seven patients received no instructions to stop smoking, and only 2 patients abstained on their own. Of the 44 patients counseled not to smoke, 12 abstained from tobacco before operation. Thus, with counseling, the cessation rate was approximately 5 times greater (chi 2 = 7.0, P = .008). A second correlation was seen when the patients were informed about tobacco's risks related to anesthesia. The smoking rate decreased from 15% to 4%, a 4-fold decrease (chi 2 = 15.3, P = .0001). The results indicate patients who smoke are not routinely informed of the risks of tobacco use or the benefits of abstinence before surgery. Counseling has a positive impact on the patient's smoking behavior in the 24 hours preceding surgery. Anesthesia providers and surgeons have a renewed obligation to instruct patients not to smoke before surgery.