[Programme to overcome tobacco dependency in cases of scheduled surgery]

Tobacco dependency is now beginning to be seen as a chronic disease. The scientific evidence of the damage it causes and the existence of efficient interventions mean it has to be tackled. In Health Area VIII of Asturias a plan to aid smokers was initiated in 1998. Now we want to extend this to patients who are going to have scheduled surgery, since it has been demonstrated that tobacco increases post-operative complications. In addition, having to confront surgery may be a reason for trying to give up tobacco.

Patients who are going to undergo surgery will be questioned and counselled on their tobacco habit during the pre-operative period. They will do the Richmond test and will be referred to the health centre if their score is >= 7.Interventions. The family doctor assesses the smokers' dependency and motivation, and offers them personalised treatment to give up. During their time in hospital, a nurse backs up their non-smoking. Once discharged, they are monitored periodically in primary care.

At the same time as the annual evaluation of the service portfolio, the number of smokers who underwent surgery and were counselled, visited on the ward and monitored in primary care will be measured. The number of patients still not smoking at one month, six months and twelve months will be recorded.

Lack of finance for the treatment may be one of the limitations of the programme. Although there are experiences in other countries of interventions in smokers who are going to have surgery, we have found no similar programme here.