OK to stop smoking shortly before surgery

January 01, 0001

OK to stop smoking shortly before surgery

These UK authors conducted a meta-analysis to examine existing smoking studies that compare surgical patients who have recently quit smoking with those who continue to smoke to provide an evidence-based recommendation for front-line staff. Concerns have been expressed that stopping smoking within 8 weeks before surgery may be detrimental to postoperative outcomes. This has generated considerable uncertainty even in health care systems that consider smoking cessation advice in the hospital setting an important priority. Data were entered into 3 separate meta-analyses that considered all available studies, studies with a low risk of bias that validated self-reported abstinence (to assess possible benefits), and studies of pulmonary complications only (to assess possible risks).

They found: "Nine studies met the inclusion criteria. One found a beneficial effect of recent quitting compared with continuing smoking, and none identified any detrimental effects. In meta-analyses, quitting smoking within 8 weeks before surgery was not associated with an increase or decrease in overall postoperative complications for all available studies (RR, 0.78, NS), for a group of 3 studies with high-quality scores (RR, 0.57, NS), or for a group of 4 studies that specifically evaluated pulmonary complications (RR, 1.18, NS)."

The authors concluded: "Existing data indicate that the concern that stopping smoking only a few weeks prior to surgery might worsen clinical outcomes is unfounded. Further larger studies would be useful to arrive at a more robust conclusion. Patients should be advised to stop smoking as early as possible, but there is no evidence to suggest that health professionals should not be advising smokers to quit at any time prior to surgery."

It is helpful to bust this myth.

For the full abstract, click here.

Arch Intern Med 171(11):983-989, 13 June 2011 © 2011 to the American Medical Association
Stopping Smoking Shortly Before Surgery and Postoperative Complications-A Systematic Review and Meta-analysis. Katie Myers, Peter Hajek, Charles Hinds, Hayden McRobbie. Correspondence to Dr. Myers: [email protected]

Category: R. Respiratory, Z. Social Problems. Keywords: smoking cessation, surgical complications, meta-analysis, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 28 June 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.