[Preoperative assessment of smoking patient]

Tobacco use can be the most common preventable cause of death. Smoking-related disorders such as pulmonary and cardiovascular diseases increase perioperative risk, and smoking itself could increase the risk of morbidity, which may be reduced by abstinence from smoking. Although the benefits of stopping smoking are generally accepted, the optimal timing of preoperative smoking cessation is an important clinical question. From the several reports, cessation should begin at least 6 to 8 weeks before surgery. However, it is important to know the fact that some important adverse effects in pulmonary and cardiovascular system induced by nicotine and CO could be restored within 24 to 48 hours of smoking cessation. Thus, even in the brief preoperative period, it is important that medical staff (including anesthesiologists, surgeons, and nurses) should advise patients to quit tobacco use.