[The smoking and drinking patient]

Daily smokers and heavy drinkers develop two to four times more complications after major as well as minor surgery. Increased postoperative morbidity is probably due to tobacco and alcohol-related organ dysfunctions which are, however, reversible during abstinence. Preoperative smoking cessation intervention for six to eight weeks significantly reduces postoperative complications after knee and hip replacement. Four weeks of preoperative alcohol intervention significantly improves organ functions before surgery, and reduces complications after colorectal surgery. Preoperative prevention programs are cost-effective. In conclusion, according to present evidence the smoking and drinking patient should be identified, informed, and offered preoperative prevention whenever possible.