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Smoking cessation and postoperative complications

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The costs of health care directly related to smoking in the United States are estimated to be in the range of $97 billion. This figure typically takes into account treatment for ailments such as lung cancer and emphysema, with the combined costs representing more than 10% of all U.S. medical expenses. New research is adding to this total estimated health cost by also assessing secondary effects, such as how smoking affects recovery time from other medical procedures.

A 2011 metastudy published in The American Journal of Medicine, “Smoking Cessation Reduces Postoperative Complications: A Systematic Review and Meta-analysis,” examined six randomized trials and 15 observational studies to look at the effects of preoperative smoking cessation on postoperative complications.

The study’s findings include:

  • The studies demonstrated decreased likelihood of postoperative complications in patients who ceased smoking prior to surgery.
  • For the six randomized trials, on average the relative risk reduction was 41% for postoperative complications.
  • Each week of cessation prior to surgery increased the magnitude of the decrease by 19%. A significant positive effect was noted in trials where smoking cessation occurred at least four weeks prior to surgery.

The United States sees an estimated 20 million general surgeries every year, and the current smoking rate across the population is about 20%. Given those numbers, the study’s findings have significant implications for how the total societal impact of smoking is measured.

Tags: cancer, medicine, metastudy

    Writer: | Last updated: April 20, 2011

    Citation: Mills E,; et al. "Smoking Cessation Reduces Postoperative Complications: A Systematic Review and Meta-analysis", American Journal of Medicine, February, 2011, Vol. 124, No. 2, 144-154.DOI: 10.1016/j.amjmed.2010.09.013.

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    Analysis assignments

    Read The American Journal of Medicine study " Smoking Cessation Reduces Postoperative Complications: A Systematic Review and Meta-analysis."

    1. Summarize the study in fewer than 40 words.
    2. Express the study's key term(s) in language a lay audience can understand.
    3. Evaluate the study's limitations. (For example: Do the results conflict with those of other reliable studies? Are there weaknesses in the study's data or research design?)

    Read the issue-related Associated Press article "Tobacco Companies Make Payments Under Pact to Help States with Smoking-related Health Care Costs."

    1. If you were to rewrite the article based on knowledge of the study, what key changes would you make?

    Newswriting assignments

    1. Write a lead (or headline or nut graph) based on the study.
    2. Spend 60 minutes exploring the issue by accessing sources of information other than the study. Write a lead (or headline or nut graph) based on the study but informed by the new information. Does the new information significantly change what one would write based on the study alone?
    3. Interview two sources with a stake in or knowledge of the issue. Be prepared to provide them with a short summary of the study in order to get their response to it. Write a 400-word article about the study incorporating material from the interviews.
    4. Spend additional time exploring the issue and then write a 1,200-word background article, focusing on major aspects of the issue.