Introduction

These authors carried out a literature review to determine the risks or benefits of short-term (less than 4 weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients.

Methods

Results

A total of 25 studies were included in the analysis. Compared with current smokers, the risk of respiratory complications was similar in smokers who gave up the habit less than 2 or 2–4 weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 versus RR 1.14; CI 0.90 to 1.45, respectively). Smokers who gave up more than 4 and more than 8 weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who gave up the habit more than 3 to 4 weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths.

Conclusions

The authors conclude that at least 4 weeks of abstinence from smoking reduces respiratory complications, and that abstinence of at least 3 to 4 weeks reduces wound-healing complications. Short-term (less than 4 weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications.