A recent report published in Suomen Lääkärilehti (Finnish Medical Journal) investigated preoperative smoking cessation practices and challenges at Finnish university hospitals. Smoking is a well-known risk factor for surgical operations and postoperative complications. In Finland, however, an estimated 40,000 patients waiting for elective surgery in 2014 were current smokers.
The report revealed that better cooperation between primary and secondary health care, as well as systematic smoking cessation procedures, could decrease the rate of smoking and associated risks for patients heading to surgery.
According to current recommendations, smoking should be quit at least eight weeks before the operation in order to achieve optimal clinical benefits. For this, primary healthcare professionals hold an important position as the first step towards smoke-free operation.
“Sometimes the elective operation can be rescheduled or even cancelled, if the patient is still smoking”, state anaesthesiologist Leena Vikatmaa and colleagues in the recent issue of Suomen Lääkärilehti.
Based on the present report, the lack of systematic recording, and missing tools for effectiveness analysis, are the major challenges. Systematic treatment procedures and nationwide registries could help to achieve better coverage and operation outcomes.
Notably, after a smoke-free operation patients may choose to remain smoke-free for the rest of their lives. Ideally, the operation is also seen as a teachable moment for making this decision.
The report was based on interviews of surgeons and clinicians who were actively engaged in developing policies and services to increase preoperative smoking cessation in their units at five university hospitals. MedEngine’s Anna Grönholm was the first author of the report which was funded by Pfizer Oy.
Grönholm A, Karhunen-Enckell U, Liira H. Tupakasta vieroitus ennen leikkausta. Suom Lääkäril 2017;72:286–9.
Vikatmaa L, Hersio K, Olkkola K. Tupakkavalistus on olennainen osa leikkauksen valmistelua. Suom Lääkäril 2017;72:255. Available online: http://www.laakarilehti.fi/ajassa/paakirjoitukset/tupakkavalistus-on-olennainen-osa-leikkauksen-valmistelua/