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Perioperative Smoking and Alcohol Cessation

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Enhanced Recovery After Surgery

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Abstract

Smoking and alcohol overconsumption cause several organ dysfunctions. The efficacy of smoking and alcohol cessation interventions is well established in the primary care setting. High to moderate quality of evidence demonstrates that both smoking and alcohol overconsumption increase morbidity. The effect of smoking on postoperative outcomes seems to be dose dependent (pack-years) and procedure specific, with higher morbidity, reoperation, and readmission rates after cardiovascular and oncologic surgery. Reduction of postoperative pulmonary complications, infections, and wound healing complications is most commonly observed after smoking cessation. Prolonged (4 weeks or longer) and intense (perioperative counseling and pharmacotherapy) smoking and alcohol cessation interventions facilitate perioperative abstinence and significantly reduce postoperative complications (high quality of evidence for smoking cessation, low quality of evidence for alcohol cessation). Although beneficial, lack of training, skills, resources, and time currently limits the implementation of smoking and alcohol cessation in the perioperative setting.

The aims of this chapter are to discuss the perioperative risks associated with smoking and alcohol overconsumption and to summarize the benefits associated with perioperative smoking and alcohol cessation. The most common perioperative smoking and alcohol cessation strategies are discussed in detail, together with the barriers limiting their utilization in the perioperative setting.

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Authors and Affiliations

  1. Department of Anesthesia, Montreal General Hospital, McGill University, Montreal, QC, Canada

    Gabriele Baldini

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  1. Gabriele Baldini
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Correspondence to Gabriele Baldini .

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Editors and Affiliations

  1. Department of Surgery, Örebro University Hospital, Örebro, Sweden

    Olle Ljungqvist

  2. Yeovil District Hospital NHS Foundation Trust Higher Kingston, Yeovil, Somerset, UK

    Nader K. Francis

  3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s, Hospital Harvard Medical School, Boston, MA, USA

    Richard D. Urman

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Baldini, G. (2020). Perioperative Smoking and Alcohol Cessation. In: Ljungqvist, O., Francis, N., Urman, R. (eds) Enhanced Recovery After Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-33443-7_8

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