By Will Boggs, MD

NEW YORK (Reuters Health) - For smokers scheduled to undergo an operation, a smoking cessation program that starts shortly before surgery lowers the rate of postop complications, a Scandinavian study shows.

The time around a surgical procedure "is a highly effective period for introducing a smoking cessation intervention, and the patients have a great chance to impact the outcome of their forthcoming surgery," Dr. David Lindstrom from the Karolinska Institute, Stockholm, told Reuters Health.

Dr. Lindstrom and colleagues investigated the effects of a quit-smoking program versus no intervention, starting 4 weeks before general and orthopedic surgery. Of the 117 patients who were enrolled, 102 were ultimately evaluated.

Nineteen patients (40 percent) in the intervention group stopped smoking for the entire study period, compared with only one patient (2 percent) in the no-intervention group, the team reports in the Annals of Surgery.

The overall postoperative complication rate was significantly lower in the smoking-cessation group (21 percent) than in the control group (41 percent).

Complications occurred in 15 percent of patients who stopped smoking at least 3 weeks before surgery, in 22 percent of those who stopped 1 to 2 weeks beforehand, and in 37 percent of those who continued smoking.

"Our collaborators in the orthopedics department are currently investigating if smoking cessation intervention started at the time of acute fracture surgery is effective in reducing postoperative complications," Lindstrom commented.

SOURCE: Annals of Surgery, November 2008.

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