title: Preoperative smoking habits and postoperative pulmonary complications.
abstract: OBJECTIVE
  To examine the effect of preoperative smoking behavior on postoperative pulmonary complications.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  The Veterans Administration Medical Center, Syracuse, NY.
  
  
  METHODS
  Patients scheduled for noncardiac elective surgery (n=410).
  
  
  RESULTS
  Smoking status was determined by self-report. Postoperative pulmonary complications were determined by systematic extraction of medical record data. Postoperative pulmonary complications occurred in 31 of 141 (22.0%) current smokers, 24 of 187 (12.8%) past smokers, and 4 of 82 (4.9%) never smokers. The odds ratio (OR) for developing a postoperative pulmonary complication for current smokers vs never smokers was 5.5 (95% confidence interval [CI], 1.9 to 16.2) and 4.2 (95% CI, 1.2 to 14.8) after adjustment for type of surgery, type of anesthesia, abnormal chest radiograph, chronic cough, history of pulmonary disease, history of cardiac disease, history of COPD, education level, pulmonary function, body mass index, and age. Current smokers who reported reducing cigarette consumption prior to surgery were more likely to develop a complication compared with those who did not (adjusted OR=6.7, 95% CI, 2.6 to 17.1).
  
  
  CONCLUSIONS
  Current smoking was associated with a nearly sixfold increase in risk for a postoperative pulmonary complication. Reduction in smoking within 1 month of surgery was not associated with a decreased risk of postoperative pulmonary complications.
authors.affiliation: Cancer Prevention, Detection and Control Research Program, Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, USA.
authors.forename: L G
authors.initials: LG
authors.lastname: Bluman
authors.forename: L
authors.initials: L
authors.lastname: Mosca
authors.forename: N
authors.initials: N
authors.lastname: Newman
authors.forename: D G
authors.initials: DG
authors.lastname: Simon
mesh_terms: D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D013514:Surgical Procedures, Operative