Smoking is a risk factor for post-operative complications, but there has also been some concern that having patients quit smoking too soon before surgery can further increase the risk. That concern is "unfounded," say U.K. researchers who have studied the effects of quitting smoking within 2 months before surgery and found "no detrimental" effects on surgical outcomes.

In an analysis of 9 studies comparing the rate of post-op complications among patients who stopped smoking within 8 weeks before surgery and those who continued to smoke, the researchers found 1 study showing that recent quitting actually had a beneficial effect, while none identified detrimental effects associated with it.

So is it safe to advise patients having surgery in less than 2 months to stop smoking? "Patients should be advised to stop smoking as early as possible," conclude the authors, led by Katie Myers, MSc, CPsychol, of Queen Mary University of London, "but there is no evidence to suggest that health professionals should not be advising smokers to quit at any time prior to surgery." Their findings were published on the website of the Archives of Internal Medicine.

In a corresponding comment article, 2 other researchers warn that the review by Ms. Myers and her colleagues "does not definitively answer the question raised," due to the limited amount of data available and some limitations and variability in their methodology. "Physicians should ideally try to get their patients to stop smoking several months prior to their surgery," write Clara Chow, PhD, of the University of Sydney and P.J. Devereaux, MD, PhD, of McMaster University in Ontario, Canada. "The appropriate advice regarding the optimal timing of smoking cessation for patients seen close to their scheduled surgery awaits further research."

Both sets of authors say larger studies of the effects of smoking cessation on surgical patients are needed to give providers a better sense of how to advise their patients on this issue.

Irene Tsikitas