There is strong evidence that smoking cessation is beneficial to long-term health. All patients are forced to become nonsmokers, if only for a short period, around the time of surgery. The perioperative period presents a unique opportunity to try and get patients to permanently stop smoking

• Globally, over 230 million adults undergo major surgery annually, and millions of these patients experience major respiratory and cardiovascular complications.
• 30% of patients undergoing surgery are smokers at the time of their surgery, and smoking is associated with an increased risk of postoperative complications, the strongest evidence being for respiratory complications.
• There is encouraging evidence that smoking cessation prior to surgery may prevent postoperative complications and increase long-term abstinence from tobacco
• Some perioperative guidelines have recommended that patients quit 8 weeks or more prior to surgery to minimize pulmonary complications that may occur when patients quit smoking within a few weeks of surgery.
• Recent quitter is a patient who quit smoking 2 to 3 days before surgery.
• Physicians should ideally try to get their patients to stop smoking several months prior to their surgery.
• The appropriate advice regarding the optimal timing of smoking cessation for patients seen close to their scheduled surgery awaits further research.
• The magnitude of the problem (ie, upwards of 70 million adult smokers worldwide undergo major surgery annually) highlights the need for large, high-quality, perioperative tobacco use studies.

For further reading log on to    http://archinte.ama-assn.org/cgi/content/full/archinternmed.2011.88