TORONTO, July 8 /CNW/ - Ontario's Anesthesiologists (OA) have unveiled a
Stop Smoking for Safer Surgery Action Plan and they are calling on all allied
health professionals involved in the surgical process to support and help
implement the plan.
"We want patients to know that smoking before surgery increases their
risk of infection, slows their recovery time and raises their readmission
rates," said Dr. Steven Bodley, Chair of Ontario's Anesthesiologists at the
Ontario Medical Association. "The Action Plan that we have developed is not
only simple and inexpensive to implement, but it will also help patients
understand the risks they face if they don't quit before surgery and the
benefits if they do."
In 2008, OA launched the Stop Smoking for Safer Surgery campaign to help
warn patients about the risks of smoking before surgery. The Action Plan
builds on the campaign by outlining several simple steps that physicians and
other health professionals can take, including:- Identifying smokers preoperatively and encouraging patients not to
smoke before surgery;
- Explaining that smoking increases risks during and after surgery;
- Referring smokers to the excellent free smoking cessation services
which are available;
- Asking patients who are scheduled for surgery when they last smoked.
When appropriate, delaying surgery to allow them to flush out the
poisons in tobacco smoke; and
- Following up with patients to encourage them to continue not smoking
after surgery.
The benefits to patients who quit smoking prior to surgery speak for
themselves. For example:
- The median length of stay for patients who quit smoking in the 6-8
weeks leading up to surgery was 11 days compared to 13 days for
patients who had simply reduced smoking by at least 50%. (Moller et
al. The Lancet 2002 Jan :114-117);
- 48% of smokers experienced breathing problems after surgery, compared
to 17% of smokers who had quit more than 8 weeks before surgery. That
number dropped to 11% for non-smokers. (Warner et al. Anesthesiology
1984; 60:380-383);
- Overall complication rates for smokers vs quitters drop from 52% to
18% (Moller et al. The Lancet 2002 Jan :114-117); and
- Wound infection rates for smokers vs non-smokers drop from 12% to 2%
(Sorensen et al. Annals of Surgery 2003 July:1-5)."The results are clear: stopping smoking has a significant impact on the
outcome of a patient's surgery," said Dr. Bodley. "I'm confident that if all
of our health care partners work together towards implementing this plan,
patients, hospitals and our health care system will be better off."
Finally, hospitals across Ontario have different policies regarding
smoking on their property. That is why Ontario's Anesthesiologists are calling
on all hospitals to become totally smoke-free by banning smoking on all
hospital property, indoors and out.Stop Smoking for Safer Surgery - Action Plan
1) Identify smokers preoperatively - As part of the preoperative
assessment, ask all patients if they smoke. Document how much they
have smoked, and for how long. Place a distinctive sticker on the
charts of smokers. Consider arranging a preoperative anesthesiology
consultation on all smokers. Place information about how to quit,
such the "Stop Smoking for Safer Surgery" poster in the preoperative
areas.
2) Explain that smoking increases risks during and after surgery -
Smokers are more likely to show signs of heart stress during surgery.
After surgery, breathing complications are more common in smokers and
they have more wound infections. Not smoking has long term health
benefits. Surgery is less likely to be successful if they continue to
smoke. Before surgery is a good a time to stop smoking.
3) Refer smokers to the excellent smoking cessation services which are
available - Smokers' Helpline - http://www.smokershelpline.ca, call
1 877 513-5333 or visit www.StopSmokingForSaferSurgery.ca. The
hospital pharmacy department or pharmaceutical companies can also
offer advice on smoking cessation aids.
4) Ask patients who are scheduled for surgery when they last smoked - If
they have smoked recently, consider delaying surgery to allow them to
excrete the poisons in tobacco smoke. Four hours of monitored smoking
cessation with supplemental oxygen will produce an acceptable carbon
monoxide level in almost all smokers.
5) Follow up with patients to encourage them to continue not smoking
after surgery - For patients who remain in hospital after surgery,
have pharmacy provide advice about nicotine patches and other
medications to help them remain smoke free. Provide a referral using
the OMA's Quit Connection program
(www.omacti.org/quit/OMA_QC_Promo_2006.pdf).
6) Call on all hospitals to become totally smoke free - Hospitals across
Ontario have different policies regarding smoking on their property.
Hospitals should consider banning smoking on all hospital property,
indoors and out.
-------------------------------------------------------------------------
These actions can reduce overall complication rates from 52% to 18%
(Moller et al. The Lancet 2002 Jan :114-117), and the wound infection
rate from 12% to 2% (Sorensen et al. Annals of Surgery 2003 July:1-5).
Stopping smoking also improves surgical outcome, reduces the likelihood
of re-operation, and in the long term, reduces the risk of COPD, many
cancers, and cardiovascular disease.
For further information: OMA Media Relations at (416) 340-2862 or
toll-free at 1-800-268-7215 ext. 2862
