title: Smokers know little of their increased surgical risks and may quit on surgical advice.
abstract: BACKGROUND
  Smoking cessation before surgery improves perioperative outcomes and some smokers may quit if undergoing surgery. Quitting smoking in community settings is influenced by physician quit advice and knowledge of smoking hazards, but there are few data on whether this applies in perioperative settings.
  
  
  METHODS
  Survey on day of surgery of elective patients who reported being a smoker at the time of wait-list placement. Duration of smoking abstinence before surgery (if any) and length timing of failed quit attempts was determined. Sources of any quit advice before surgery, including from physicians, and patient knowledge on hazards of smoking and surgery were questioned.
  
  
  RESULTS
  While on the waiting list, 44/177 smokers reported quitting (>24 h) before surgery and 42/177 others made an attempt. Quitting was usually brief. Fewer than 40% of smokers answered yes (correct answer) to questions on whether smoking increased wound infection rates, worsened wound healing, increased anaesthetic complications or increased post-operative pain. Incorrect answers (no) were less likely in quitters than those smoking until surgery (OR 0.41, 95% CI 0.25-0.68). Patients still smoking by admission recalled quit advice from a surgeon in 22.6% of cases, while wait-list quitters recalled surgical quit advice in 43.2% of cases (OR 2.6 95% CI 1.2-5.4 P = 0.01). Effects of general practitioner quit advice were significant (OR 3.2 95% CI 1.5-6.8 P = 0.004) while anaesthetists, nurse and hospital brochure advice were not.
  
  
  CONCLUSIONS
  Improving patient knowledge of the perioperative risks of smoking and increased physician advice to quit may improve smoking abstinence at surgery.
authors: Department of Anaesthesia and Pain Management, Peninsula Health, Frankston, Victoria, Australia.
authors: Ashley R
authors: AR
authors: Webb
authors: Nicola
authors: N
authors: Robertson
authors: Maryanne
authors: M
authors: Sparrow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D037001:Directive Counseling; D017558:Elective Surgical Procedures; D005260:Female; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000706:statistics & numerical data*
keywords: health knowledge; perioperative risk; smoking; surgery; tobacco