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A Systematic Approach to Perioperative Smoking Cessation

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Date
2020-01-01
Authors
Davis, JM
Thomas, LC
Dirkes, JEH
Aronson, S
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Abstract
© 2020 Wolters Kluwer Health, Inc. All rights reserved. Background:There is compelling evidence that smoking leads to poor postoperative outcomes including increased incidence of wound infection, respiratory infection, sepsis, cardiac arrest, and mortality. There is also compelling evidence that smoking cessation before surgery leads to improved outcomes. A recent meta-analysis found that brief smoking interventions may be insufficient to change postoperative outcomes. However, more intensive evidence-based smoking cessation interventions do improve postoperative outcomes and lead to long-term smoking abstinence. From a healthcare perspective, this raises a question of how to best provide effective perioperative smoking cessation treatment to a population.Methods:Duke University Health System recently developed a systematic approach to perioperative smoking cessation. In this report, we outline evidence-based principles for perioperative smoking cessation and describe initial results from a perioperative smoking cessation program.Results:In the first 100 days of the Duke Perioperative Smoking Cessation Program, we received 420 referrals. Participants had a mean pack-year history of 50.3 (packs/day×years smoking; SD 32.5), a mean Fagerström Test for Nicotine Dependence score of 4.5 (SD 2.5), and a mean expired breath carbon monoxide of 11.8 (SD 7.5) parts per million. Mean days from initial perioperative smoking cessation visit to surgery was 21.4 (SD 22.3).Discussion:This model of perioperative smoking cessation is in the early stages of development; however, evidence-based perioperative smoking cessation services can be effective across a health system.
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Journal article
Permalink
https://hdl.handle.net/10161/21394
Published Version (Please cite this version)
10.1097/BTO.0000000000000435
Publication Info
Davis, JM; Thomas, LC; Dirkes, JEH; & Aronson, S (2020). A Systematic Approach to Perioperative Smoking Cessation. Techniques in Orthopaedics, 35(1). pp. 25-30. 10.1097/BTO.0000000000000435. Retrieved from https://hdl.handle.net/10161/21394.
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Scholars@Duke

Aronson

Solomon Aronson

Professor Emeritus of Anesthesiology
Solomon Aronson, MD, MBA, FACC, FACCP, FAHA, FASE  Solomon Aronson is a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. Dr. Aronson earned his BS in molecular biology with distinction at the University of Wisconsin in Madison, and his MD with honors in research at the Medical College of Wisconsin in Milwaukee. After completing an anesthesiology residency including a year as chief resident at the Univer
Davis

James Davis

Associate Professor of Medicine
Dr. James Davis is a practicing physician of Internal Medicine, and serves as the Medical Director for Duke Center for Smoking Cessation, Director of the Duke Smoking Cessation Program and Co-Director of the Duke-UNC Tobacco Treatment Specialist Credentialing Program.  His research focuses on development of new pharmaceutical treatments for smoking cessation.  He is principal investigator on several trials including a study on “adaptive” smoking cessation and several trials
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