Patients' awareness of the surgical risks of smoking: Implications for supporting smoking cessation

Objective: To describe the smoking patterns of patients receiving elective surgery and their knowledge about the benefits of smoking cessation to inform and strengthen support for patients to quit smoking in order to optimize surgical outcomes. Design: Patients who had elective surgery were screened for smoking status, and eligible patients completed a telephone survey. Setting: Two regional hospitals in northern British Columbia. Participants: Of 1722 patients screened, 373 reported smoking before surgery. Of these, 161 (59.0% women) completed a telephone survey. Main outcome measures: Patient smoking cessation, knowledge of the perioperative risks of smoking, use of resources, and health care provider advice and assistance. Results: Participants included 66 men and 95 women (mean [SD] age of 51.9 [14.0] years). In total, 7.5% of these patients quit smoking in the 8 weeks before their surgeries, although an additional 38.8% reduced their smoking. Only about half of the patients surveyed were aware that continuing to smoke increased their surgical risks. Further, only half of the patients surveyed reported being advised to quit before their surgeries by a health care professional. Few were using the provincial resources available to support smoking cessation (eg, QuitNow), and 39.6% were unaware of the provincial program to cover the cost of smoking cessation aids (eg, nicotine gum or patches), yet 62.7% of respondents were thinking about quitting smoking. Conclusion: Many surgical patients in northern British Columbia who smoked were unaware of the perioperative risks of smoking and the cessation support available to them. An opportunity exists for all health care professionals to encourage more patients to quit in order to optimize their surgical outcomes.

This research was supported by the Canadian Cancer Society Research Institute (Grant #701259-00).