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British Journal of Anaesthesia 2009 102(3):297-306; doi:10.1093/bja/aen401
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2009. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Smoking and alcohol intervention before surgery: evidence for best practice

H. Tønnesen1,*, P. R. Nielsen3, J. B. Lauritzen2 and A. M. Møller4

1 WHO Collaborating Centre for Evidence Based Health Promotion in Hospitals and Health Services
2 Orthopedic Department, Bispebjerg University Hospital, DK-2400 Copenhagen, Denmark
3 Pain Clinic, The Neuroscience Center, Rigshospitalet, University of Copenhagen, Blegdamsvej 3, DK-2100 Copenhagen, Denmark
4 Department of Anaesthesiology, Herlev University Hospital, Herlev Ringvej, DK-2730 Herlev, Denmark

* Corresponding author. E-mail: hanne.tonnesen{at}bbh.regionh.dk

Smoking and hazardous drinking are common and important risk factors for an increased rate of complications after surgery. The underlying pathophysiological mechanisms include organic dysfunctions that can recover with abstinence. Abstinence starting 3–8 weeks before surgery will significantly reduce the incidence of several serious postoperative complications, such as wound and cardiopulmonary complications and infections. However, this intervention must be intensive to obtain sufficient effect on surgical complications. All patients presenting for surgery should be questioned regarding smoking and hazardous drinking, and interventions appropriate for the surgical setting applied.

Keywords: alcohol, drinking; complications, postoperative; lifestyle intervention; risk factors; smoking; surgery


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