Smoking & Blood Flow Don’t Mix

Vascular surgery patients more likely to quit smoking with doctor counseling

(RxWiki News) Doctors don’t give advice for fun—they give it for the patient’s health. So when a doctor advises a patient to quit smoking, it’s to help save his or her life.

A recent study asked vascular surgery patients if they quit smoking after surgery. Researchers found that those patients who were either counseled by their doctors to quit, given smoking cessation medication or referred to a smoking cessation specialist were nearly 50 percent more successful at quitting than patients who were told nothing.

"Quit smoking before vascular surgery."

Andrew Hoel, MD, from the Division of Vascular Surgery at Dartmouth-Hitchcock Medical Center in New Hampshire, led an investigation into patients who either did or did not quit smoking after having a vascular surgery.

For the study, 7,807 patients involved in the Vascular Study Group of New England were asked about their smoking habits before surgery and again one year after surgery.

All of the participants underwent one of the following vascular surgeries between 2003 and 2009:

  • Carotid endarterectomy: This surgery removes plaque buildup in the main artery in the throat that supplies blood from the heart to the brain to prevent a stroke.
  • Carotid artery stenting: Surgeons insert a small mesh tube to prop open the main artery in the neck that supplies blood from the heart to the brain to prevent a stroke.
  • Lower extremity bypass: Surgeons create an alternative blood flow route that is attached to arteries that send blood to the legs, completely bypassing the blocked, original arteries.
  • Open or endovascular abdominal aortic aneurysm repair: Surgeons repair a portion of the artery that has ballooned so it doesn’t burst. Open repair uses larger incisions in the patient, while endovascular repair uses cameras and surgical instruments inserted through small incisions.

At the time of surgery, 33 percent of the patients reported that they were current smokers. Of the smokers, 45 percent quit smoking within a year after surgery.

Broken down by surgical procedure from most to least invasive, the following percentages of patients had quit smoking after surgery:

  • 50 percent of open abdominal aortic aneurysm repair
  • 49 percent of endovascular abdominal aortic aneurysm repair 
  • 46 percent of lower extremity bypass 
  • 43 percent of carotid endarterectomy 
  • 27 percent of carotid artery stenting 

Patients over 70 years of age were almost twice as likely to quit smoking. Patients on dialysis were two and a half times more likely to quit smoking.

Researchers noted that the healthcare facility where the patient was treated played a significant role in whether or not a patient quit smoking. Overall smoking cessation rates varied from 28 percent to 62 percent for patients, based on where they were treated.

A total of 78 percent of patients reported that they had been offered smoking cessation medications and/or were referred to a smoking cessation specialist.

Successful smoking cessation rates were 48 percent for those patients who were offered smoking cessation help compared to 33 percent for patients who were not offered any help.

Based on the varied success of certain treatment centers compared to others, the authors concluded that vascular surgeons have a great chance to influence patients to quit smoking at the time of surgery.

This study was published in January in the Journal of Vascular Surgery.

Review Date: 
February 12, 2013