title: The effect of pre-operative counselling on smoking patterns in patients undergoing forefoot surgery.
abstract: BACKGROUND
  Smoking contributes to higher surgical complication rates. Previous studies assessing smoking cessation interventions examined the provision of comprehensive packages. The use of surgery as an incentive to complement brief advice has not been fully evaluated.
  
  
  METHODS
  Smokers were counselled and referred to their general practitioners for specific cessation strategies. Smoking status was recorded prior to surgery, on admission and in post-operative clinics. A telephone survey at a mean of 12 months post-operation ascertained long-term behavioural changes.
  
  
  RESULTS
  Ninety-seven patients underwent surgery with twenty-five recorded as smokers. Sixteen stopped smoking pre-operatively; a further four reduced their intake, as a direct consequence of counselling. No patients were previously aware of the detrimental effects of smoking associated with foot surgery.
  
  
  CONCLUSIONS
  Surgery provides an incentive for smoking cessation, maintained post-operatively. Although forefoot fusions and arthrodeses were used in our study, the results are transferable to other branches of orthopaedic surgery.
authors.affiliation: Trauma and Orthopaedic Department, Queen Margaret Hospital, Dunfermline, Fife KY12 0SU, UK. neilwalker@doctors.org.uk
authors.forename: N M
authors.initials: NM
authors.lastname: Walker
authors.forename: S A C
authors.initials: SA
authors.lastname: Morris
authors.forename: L B
authors.initials: LB
authors.lastname: Cannon
mesh_terms: D001174:Arthrodesis; D003376:Counseling; D005528:Foot / Q000601:surgery*; D006801:Humans; D010027:Osteotomy; D011183:Postoperative Complications / Q000517:prevention & control*; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome