Effects of Preoperative Smoking Cessation on the Incidence and Risk of Intraoperative and Postoperative Complications in Adult Smokers: a Systematic Review

Overview

Journal Tob Control

Specialty Psychiatry

Date 2006 Sep 26

PMID 16998168

Citations 57

Authors

Alice Theadom

Mark Cropley

Affiliations

Soon will be listed here.

Abstract

Objectives: To establish the effect of preoperative smoking cessation on the risk of postoperative complications, and to identify the effect of the timing of preoperative cessation.

Data Sources: The Cochrane Library Database, PsycINFO, EMBASE, Medline, and CINAHL databases were searched, using the terms: "smoking", "smoking-cessation", "tobacco-use", "tobacco-abstinence", "cigarett$", "complication$", "postoperative-complication$", "preoperative", "perioperative" and "surg$". Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to November 2005.

Study Selection: Prospective cohort designs exploring the effects of preoperative smoking cessation on postoperative complications were included. Two reviewers independently scanned abstracts of relevant articles to determine eligibility. Lack of agreement was resolved through discussion and consensus. Twelve studies met the inclusion criteria.

Data Extraction: Methodological quality was assessed by both reviewers, exploring validation of smoking status, clear definition of the period of smoking cessation, control for confounding variables and length of follow-up.

Data Synthesis: Only four of the studies specified the exact period of smoking cessation, with six studies specifying the length of the follow-up period. Five studies revealed a lower risk or incidence of postoperative complications in past smokers than current smokers or reported that there was no significant difference between past smokers and non-smokers.

Conclusions: Longer periods of smoking cessation appear to be more effective in reducing the incidence/risk of postoperative complications; there was no increased risk in postoperative complications from short term cessation. An optimal period of preoperative smoking cessation could not be identified from the available evidence.

Citing Articles

The effect of tobacco use on clinical outcomes in total knee arthroplasty patients.

Parry D, Allen J, Henderson B, Kassab J, Hernandez E, Brindley G Proc (Bayl Univ Med Cent). 2025; 38(2):171-174.

PMID: 39989994 PMC: 11845058. DOI: 10.1080/08998280.2024.2441633.

Sex-based analysis of characteristics contributing to anorectal abscesses requiring acute care surgery.

Balan N, Liu J, Braschi C, Lee H, Petrie B Surg Pract Sci. 2025; 12():100156.

PMID: 39845300 PMC: 11749951. DOI: 10.1016/j.sipas.2023.100156.

Impact of smoking status on engagement in remote symptom monitoring after oncologic surgery: Implications for symptom management and readmission rates.

Cracchiolo J, Li Y, Lui M, Carlsson S, Matulewicz R, Ostroff J Cancer. 2025; 131(3):e35708.

PMID: 39840908 PMC: 11893011. DOI: 10.1002/cncr.35708.

Prospective study on the effects of mechanical bowel preparation under the enhanced recovery after surgery concept on electrolyte disturbances and functional recovery after robotic surgery for urologic tumors in older adults.

Liu H BMC Urol. 2024; 24(1):184.

PMID: 39198778 PMC: 11351007. DOI: 10.1186/s12894-024-01577-7.

Time to Start a New Enhanced Recovery After Surgery (ERAS): A Retrospective Cohort Study.

Rodrigues R, Abreu J, Goncalves B, Luis M, Freitas C Cureus. 2024; 16(5):e60301.

PMID: 38872706 PMC: 11175708. DOI: 10.7759/cureus.60301.

References

Celli B . Perioperative respiratory care of the patient undergoing upper abdominal surgery. Clin Chest Med. 1993; 14(2):253-61. View

Kolh P, Comte L, Tchana-Sato V, Honore C, Kerzmann A, Mauer M . Concurrent coronary and carotid artery surgery: factors influencing perioperative outcome and long-term results. Eur Heart J. 2005; 27(1):49-56. DOI: 10.1093/eurheartj/ehi494. View

Rigotti N, McKool K, Shiffman S . Predictors of smoking cessation after coronary artery bypass graft surgery. Results of a randomized trial with 5-year follow-up. Ann Intern Med. 1994; 120(4):287-93. DOI: 10.7326/0003-4819-120-4-199402150-00005. View

Nigrovic V, Wierda J . Post-succinylcholine muscle pain and smoking. Can J Anaesth. 1994; 41(5 Pt 1):453-4. DOI: 10.1007/BF03009880. View

Rice V, Fox D, Lepczyk M, Sieggreen M, Mullin M, Jarosz P . A comparison of nursing interventions for smoking cessation in adults with cardiovascular health problems. Heart Lung. 1994; 23(6):473-86. View

Henningfield J . Nicotine medications for smoking cessation. N Engl J Med. 1995; 333(18):1196-203. DOI: 10.1056/NEJM199511023331807. View

Teiria H, Rautoma P, Yli-Hankala A . Effect of smoking on dose requirements for vecuronium. Br J Anaesth. 1996; 76(1):154-5. DOI: 10.1093/bja/76.1.154. View

Dresler C, Bailey M, Roper C, Patterson G, Cooper J . Smoking cessation and lung cancer resection. Chest. 1996; 110(5):1199-202. DOI: 10.1378/chest.110.5.1199. View

Hasdai D, Garratt K, Grill D, Lerman A, Holmes Jr D . Effect of smoking status on the long-term outcome after successful percutaneous coronary revascularization. N Engl J Med. 1997; 336(11):755-61. DOI: 10.1056/NEJM199703133361103. View

10.

Gourlay S, Benowitz N . Arteriovenous differences in plasma concentration of nicotine and catecholamines and related cardiovascular effects after smoking, nicotine nasal spray, and intravenous nicotine. Clin Pharmacol Ther. 1997; 62(4):453-63. DOI: 10.1016/S0009-9236(97)90124-7. View

11.

Bluman L, Mosca L, Newman N, Simon D . Preoperative smoking habits and postoperative pulmonary complications. Chest. 1998; 113(4):883-9. DOI: 10.1378/chest.113.4.883. View

12.

Woehlck H, Connolly L, Cinquegrani M, Dunning 3rd M, Hoffmann R . Acute smoking increases ST depression in humans during general anesthesia. Anesth Analg. 1999; 89(4):856-60. DOI: 10.1097/00000539-199910000-00008. View

13.

Warner D, Sarr M, Offord K, Dale L . Anesthesiologists, general surgeons, and tobacco interventions in the perioperative period. Anesth Analg. 2004; 99(6):1766-1773. DOI: 10.1213/01.ANE.0000136773.40216.87. View

14.

Warner D . Preoperative smoking cessation: the role of the primary care provider. Mayo Clin Proc. 2005; 80(2):252-8. DOI: 10.4065/80.2.252. View

15.

Moore S, Mills B, Moore R, Miklos J, Mattox T . Perisurgical smoking cessation and reduction of postoperative complications. Am J Obstet Gynecol. 2005; 192(5):1718-21. DOI: 10.1016/j.ajog.2004.11.048. View

16.

Lavernia C, Sierra R, Gomez-Marin O . Smoking and joint replacement: resource consumption and short-term outcome. Clin Orthop Relat Res. 1999; (367):172-80. View

17.

Moores L . Smoking and postoperative pulmonary complications. An evidence-based review of the recent literature. Clin Chest Med. 2000; 21(1):139-46, ix-x. DOI: 10.1016/s0272-5231(05)70013-7. View

18.

Chang D, Reece G, Wang B, ROBB G, Miller M, EVANS G . Effect of smoking on complications in patients undergoing free TRAM flap breast reconstruction. Plast Reconstr Surg. 2000; 105(7):2374-80. DOI: 10.1097/00006534-200006000-00010. View

19.

Chimbira W, Sweeney B . The effect of smoking on postoperative nausea and vomiting. Anaesthesia. 2000; 55(6):540-4. DOI: 10.1046/j.1365-2044.2000.01474.x. View

20.

Moller A, Maaloe R, Pedersen T . Postoperative intensive care admittance: the role of tobacco smoking. Acta Anaesthesiol Scand. 2001; 45(3):345-8. DOI: 10.1034/j.1399-6576.2001.045003345.x. View