The necessity and timing of smoking cessation before scheduled cardiovascular interventions – doctors' survey

Abstract

Background. No specific time frames are specified in the guidelines for smoking cessation for patients preparing for cardiovascular intervention. Current smoking is an adverse prognostic factor according to the Russian and foreign legal documents, but the recommendations do not specify the timing of smoking cessation, even though it could help minimize postoperative complications and improve the prognosis. Aim. To analyze doctors' opinions on the necessity and timing of smoking cessation for patients before scheduled cardiovascular surgery. Material and methods. 320 specialists 250 (78.1%) general practitioners and 70 (21.9%) surgeons, were surveyed, each participant had at least 10 years of experience performing preoperative program before coronary artery bypass graft surgeries or other interventions and providing postoperative rehabilitation. The questionnaire included seven questions reflecting the doctors' opinion on the feasibility, timing and limiting factors of smoking cessation in patients referred for planned coronary artery bypass graft surgery. Results. Most of the respondents 218 (68.1%) people would recommend patients to stop smoking during preoperative period; fewer specialists 102 (31.9%), would advise them to quit smoking after surgery. The majority of respondents, 166 (76.2%) doctors, believe that patients should quit smoking 2 months before the operation. A third of respondents said it would be appropriate to stop smoking after surgical treatment: 31 (30.4%) specialists recommended it immediately after the operation; 43 (42.1%) within the first month. The majority of respondents noted an increased risk of patients health deterioration, such as: increased cough according to 200 (62.5%) specialists; sputum secretion 85 (26.6%); shortness of breath 25 (7.8%); and 10 (3.1%) doctors mentioned the risk of developing withdrawal syndrome and anxiety. All of those are the reasons why experts consider not recommending patient to stop smoking during preoperative period. Conclusion. Doctors, involved in the caring for and management of cardiac surgery patients, do not have unanimous opinion on the time frames of smoking cessation.

Keywords

• coronary artery disease
• smoking
• smoking cessation
• cardiovascular intervention