The physiological effects of short-term smoking cessation in claudicants.
BACKGROUND
Smoking contributes to atherosclerosis and causes significant postoperative morbidity. New antismoking law forces short-term pre-operative abstinence. Demonstrable clinical benefit might motivate complete cessation. Our aim was to determine the effects of 24-hr smoking cessation on cardiorespiratory function and claudication distance.


METHODS
Smoking claudicants were randomized to 24hr smoking or abstinence. Following these separate periods, cardiopulmonary exercise testing was performed. Pre- and post-exercise, serum lactate and ankle brachial pressure index (ABPI) were measured. During exercise, cardiorespiratory function, initial and absolute claudication (IC,AC) distances and visual analogue scores (VAS) of pain were recorded.


RESULTS
16 patients completed both tests. IC, AC and VAS were unchanged with abstinence (P = .43, .66, .96, .83). ABPI drop post-exercise was unchanged with abstinence (P = .08, .09). Cardiorespiratory function was not affected by smoking cessation.


CONCLUSIONS
Cardiorespiratory function and claudication symptoms are unchanged following 24-hr smoking cessation. No deterioration in respiratory function is important when considering anaesthetic administration. However, lack of symptomatic improvement may discourage patients from abstaining. Further investigation should determine correlation between short-term abstinence and postoperative morbidity.
Dickinson
K J
KJ
Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom. kdickinson0@hotmail.com
Cockbain
A J
AJ
MacDonald
W
W
Shah
M
M
Homer-Vanniasinkam
S
S
D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation / Q000379:methods*; D013997:Time Factors