Ditching Tobacco for Your Surgery

Providers across Michigan took action to get their patients to quit smoking before going under the knife.

A new initiative brought providers across the state together on a common mission: address the high smoking rates they were seeing in their patients before wheeling them into the operating room.

Smoking is linked to many serious health issues, yet a recent study found almost a quarter of people undergoing common surgeries report smoking cigarettes.

Over the last few years, providers of nearly 14,000 patients undergoing vascular surgery in Michigan brought three components into exam rooms: physician counseling, nicotine replacement therapy, and referral to the Michigan Tobacco Quitline

“This study evaluated a smoking cessation initiative that the Michigan Cardiovascular Consortium (BMC2) started in 2018 to help patients quit smoking after undergoing vascular surgery,” explained senior author Peter Henke, MD, a professor of surgery and the interim section chief of vascular surgery at the University of Michigan Health Frankel Cardiovascular Center.

The new study, published in the Journal of Vascular Surgery, found that more than a third of patients had ditched cigarettes a month after their vascular surgery procedure, and 43% had quit a year after their surgery – a striking improvement to the average annual quit rates of below 10%, the authors said.

“These results tell us that patients can achieve impressive quit rates after surgery, that delivering smoking cessation interventions at a large scale is feasible, and that they are effective in helping patients quit in the short-term,” said lead author Ryan Howard, MD, a U-M general surgery resident.

However, Howard noted that the higher quit rate observed 30 days after surgery wasn’t maintained after a year. “Clearly future efforts will need to focus on long-term effectiveness as well,” he added.

Howard has said that the experience of going through surgery can be a teachable moment for patients who are more receptive to health changes that will help them heal well, making it an ideal time to address smoking.

Paper cited: “Impact of a Regional Smoking Cessation Intervention for Vascular Surgery Patients,” Journal of Vascular Surgery. DOI: 10.1016/j.jvs.2021.07.103

Blue Cross Blue Shield of Michigan and Blue Care Network funded this research as part of its support of quality initiatives including BMC2, one of its collaborative quality initiatives in Michigan.