Preoperative smoking cessation counseling activities of anesthesiologists: a cross-sectional study.
BACKGROUND
Smokers undergoing surgery are at a higher risk of complications than non-smokers. Preoperative evaluation by an anesthesiologist could provide an excellent opportunity to promote smoking cessation. Previous surveys of anesthesiologists have found that self-reported smoking cessation counseling rates have room for improvement, but no study has surveyed patients to obtain more accurate estimates.


METHODS
A single-center study was conducted from January 2010 to June 2010 in a tertiary teaching hospital. A telephone survey was conducted, which included all adult cigarette smokers who visited the preoperative anesthesia clinic. The survey recorded anesthesiologist-delivered interventions to help patients quit smoking before surgery. At the end of the study period, the self-reported smoking cessation counseling of the anesthesiologist was evaluated by questionnaire.


RESULTS
One thousand one hundred and sixty-five patients were evaluated, of which 217 were current smokers with a median pack-year of 15 (interquartile range 5.25-30.00) and 34% were scheduled to undergo major surgery. With regard to preoperative interventions, most anesthesiologists (85%) asked about smoking status, although only 31% advised patients about the health risks of smoking and 23% advised patients to quit before surgery. Provision of assistance to help patients quit was provided in 3% of cases. By contrast, 75% of anesthesiologists stated that they frequently or almost always advised patients about the health risks of smoking.


CONCLUSIONS
This study shows significant discrepancies between direct patient surveys of preoperative smoking cessation counseling activities by anesthesiologists and the self-reported perceptions of the anesthesiologists. Future studies are urgently needed to evaluate the provision of educational materials and other interventions to improve smoking cessation counseling rates among anesthesiologists and to narrow these discrepancies.
Department of Toxicology, Faculty of Medicine Complutense University, Madrid, Spain. mati@plagaro.net.|Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. mati@plagaro.net.
Matilde
M
Zaballos
Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. marilucanal@gmail.com.
Maria Iluminada
MI
Canal
Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. troporo@hotmail.com.
Rocío
R
Martínez
Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. mariajoski@hotmail.com.
Maria José
MJ
Membrillo
Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. pacogmoraga@yahoo.es.
Francisco J
FJ
Gonzalez
Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. hdavid.orozco@gmail.com.
Hugo D
HD
Orozco
Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. fjsanzf1257@gmail.com.
Francisco J
FJ
Sanz
Head of the Department of Anesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. mlopezgi@yahoo.es.
Maite
M
Lopez-Gil
D000328:Adult; D000368:Aged; D000776:Anesthesiology; D003376:Counseling / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards*; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011229:Preanesthetic Medication / Q000379:methods; D011300:Preoperative Care / Q000592:standards; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires