Dr. Casale: Post-surgery outcomes better for non-smokers

By Alfred Casale To Your Health



Happy American Heart Month to all!

In recognition of this annual awareness campaign, and with the heart on the mind as Valentine’s Day approaches, I’d like to offer you yet another great reason to do the heart-healthy thing and quit smoking.

A recent report from the World Health Organization (WHO) declares that people who quit smoking are at significantly lower risk of complications after surgery.

Before we even get into it, just a friendly reminder that the American Heart Association calls smoking “the most important preventable cause of premature death in the United States.” The narrowed blood vessels, plaque buildup and high blood pressure caused by smoking dramatically increases a person’s risk of developing cardiovascular disease or having a heart attack or stroke.

Other than the obvious compromise of your overall health, smoking increases your chances of developing infection, impaired heart and lung function, and slow or improper wound healing following surgery. Cigarettes contain nicotine and increase the amount of carbon monoxide in the blood, which can deplete oxygen levels and worsen risk of heart complications after surgery. Pulmonary complications are also more prevalent, since smoking damages the lungs and impedes air flow. Finally, smoking weakens the immune system, hurting the body’s ability to heal.

A new study by the WHO, University of Newcastle, Australia, and the World Federation of Societies of Anesthesiologists concludes that smokers who quit four weeks or more before surgery have lower risk of complication and better results six months after surgery.

Quitting smoking improves blood flow to essential organs, so every week of smoking cessation beyond the fourth week improves post-surgery outcomes by 19 percent. This new knowledge has important implications. The most notable, though, is that outcomes can be improved if patients are urged, and allowed enough time, to quit smoking prior to surgery. If the 1.1 billion people who smoke worldwide decided to quit tomorrow, a major obstacle in caring for people — the looming risk of post-surgery complications — could be alleviated.

And let’s not forget the countless other good reasons to quit smoking. Chief among them are improved breathing and circulation and decreased risk of developing cardiovascular disease and cancer. Proving that it’s never too late to quit, heart rate and blood pressure decrease 20 minutes after stopping; carbon monoxide in the blood reaches normal levels after 12 hours; and circulation and lung function improve after 2 weeks.

Quitting smoking is difficult, but it’s also accomplished every day, and the benefits of ceasing far outweigh the challenges of breaking the habit. When attempting to put smoking behind you, it’s important to stick to a plan.

Setting a goal can help you stay on track. Choosing a day as a deadline or a “quit day” can help you achieve your goal. If you know your deadline is approaching, you can take steps to prepare.

Quitting outright, or “cold turkey,” on your quit day is ideal, but leading up to the day, you can cut down on how many cigarettes you smoke each day or how much of each cigarette you smoke before putting it out. These smaller sacrifices can be good training for quitting completely when your deadline is at hand.

Remember, if you need help quitting, talk to your doctor. Medications and other therapies are available for those who require additional aid. And it’s important to prepare for an overall lifestyle change when confronting this challenge.

Being prepared with healthy foods can help quell pangs of hunger as well as satisfy an established oral fixation. Think lots of raw veggies and nuts, for example. Healthy activity is another good way to keep your mind off of smoking. Exercise, recreational activity, artistic outlets, and any healthy endeavor that keeps your hands busy are good contingency plans for those first few days and the tobacco-free life that follows.

Regardless of the way you choose to quit, you’ll be glad you did.

Dr. Alfred Casale, a cardiothoracic surgeon, is chief medical officer for surgical services for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via [email protected] For information on alternative treatment for atrial fibrillation, visit https://geisinger.cc/2E2N8n8