Surgical Tribune International

Smoking cessation decreases risk of postoperative complications

By Surigcal Tribune
January 29, 2020

GENEVA, Switzerland: Approximately one in 25 individuals—representing between 187 million and 280 million cases globally—undergoes major surgery annually for the treatment of disease, injury or illness. Although medical treatments are constantly evolving, postsurgical complications continue to represent a substantial burden for both patients and healthcare systems. A recent review investigated the correlation between smoking and postsurgical risks and found that tobacco smokers are at significantly higher risk than non-smokers for postsurgical complications.

The joint review by the World Health Organization (WHO), the University of Newcastle in Callaghan in Australia and the World Federation of Societies of Anaesthesiologists found that smokers who quit approximately four weeks or more before surgery had a lower risk of complications and better results at six months follow up. Every tobacco-free week after four weeks improved health outcomes by 19%, owing to improved blood flow throughout the body to essential organs. In addition, patients who quit smoking tobacco were less likely to experience complications with anaesthesia compared with regular smokers.

“The report provides evidence that there are advantages to postponing minor or non-emergency surgery to give patients the opportunity to quit smoking, resulting in a better health outcome,” said Dr Vinayak Mohan Prasad, Head of the WHO Tobacco Free Initiative.

Nicotine and carbon monoxide, both present in cigarettes, can decrease oxygen levels and greatly increase risk of heart-related complications after surgery. Smoking tobacco also damages the lungs making it difficult for the proper amount of air to flow through, increasing the risk of postsurgical complications. Smoking distorts a patient’s immune system and can delay healing, increasing the risk of infection at the wound site. Smoking just one cigarette decreases the body’s ability to deliver necessary nutrients for healing after surgery.

“Complications after surgery present a large burden for both the health care provider and the patient.  Primary care physicians, surgeons, nurses and families are important in supporting a patient to quit smoking at every stage of care, especially before an operation,” said Dr Shams Syed, Coordinator of the Quality Systems and Resilience Unit at WHO. The WHO encourages countries to include cessation programmes and educational campaigns in their health systems to spread awareness and help people to quit smoking.

The review, titled WHO tobacco knowledge summaries: tobacco and postsurgical outcomes, was published in January 2020.

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