A Systematic Approach to Perioperative Smoking Cessation
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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https://hdl.handle.net/10161/21394Published Version (Please cite this version)
10.1097/BTO.0000000000000435Publication 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.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
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
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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