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Smokers And What They Face Before, After Surgery

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Smokers having elective surgery face a slew of potential health problems including wound infection, respiratory failure, prolonged hospital stay and multiple complications after surgery. John Maa, M.D., said surgeons should use the five A’s: Ask patients if they smoke; advise them to quit; assess previous attempts to quit; assist them with nicotine replacement; and arrange a follow-up meeting. The National Health Service policy in Great Britain requires smokers awaiting elective surgery to complete a weeklong smoking cessation program. Most surgeons in the United States do not require patients to attend smoking cessation courses because of competing interests; if smokers don’t want to attend a cessation course, they will simply find another surgeon. Dr. Maa also said mandatory smoking cessation courses could lead to discrimination against smokers and a fear that surgeons would be stigmatizing smokers.