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Smoking and alcohol intervention before surgery: evidence for best practice
H Tønnesen1, P R Nielsen, J B Lauritzen
1WHO Collaborating Centre for Evidence Based Health Promotion in Hospitals and Health Services, Copenhagen, Denmark. hanne.tonnesen@bbh.regionh.dk
British Journal of Anaesthesia
|February 17, 2009
Summary
Quitting smoking and hazardous drinking 3-8 weeks before surgery significantly reduces serious postoperative complications. Intensive interventions are crucial for this surgical patient population to improve outcomes.
Area of Science:
- Surgery
- Addiction Medicine
- Public Health
Background:
- Smoking and hazardous drinking are significant risk factors for surgical complications.
- These behaviors cause organic dysfunctions that can be reversed with abstinence.
Purpose of the Study:
- To evaluate the impact of pre-operative abstinence from smoking and hazardous drinking on surgical complications.
- To determine the optimal timing and intensity of interventions for surgical patients.
Main Methods:
- Review of pathophysiological mechanisms linking substance use to surgical outcomes.
- Analysis of complication rates in patients abstaining from smoking and hazardous drinking prior to surgery.
Main Results:
- Pre-operative abstinence for 3-8 weeks substantially lowers the incidence of wound, cardiopulmonary, and infectious complications.
- Intensive intervention is necessary to achieve a significant reduction in surgical complications.
Conclusions:
- Pre-operative cessation of smoking and hazardous drinking is an effective strategy to mitigate surgical risks.
- Screening all surgical patients for these behaviors and implementing targeted interventions is recommended.
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