Kick smoking habit, especially before surgery

By Drs. Bruce Snyder and Rob Morgan

This was originally published in The Greenville News as a Guest Column on November 16, 2013.

Thursday, Nov. 21, marks the Great American Smokeout, a day the American Cancer Society has designated to encourage smokers to quit smoking, or to develop a plan for doing so. As physicians with over three combined decades of experience caring for patients, many of whom suffer from chronic diseases related to the long-term use of tobacco products, we are the first to acknowledge that it isn’t easy.

The facts about smoking haven’t changed. Nearly 1 in 5 Americans continue to smoke, and tobacco use remains the single largest preventable cause of disease and premature death in the United States (www.cancer.org/healthy/stayawayfromtobacco/greatamericansmokeout/index). The rate of smoking in South Carolina exceeds the national average, and tobacco use costs our state an estimated $5 billion every year in premature deaths, lost workplace productivity, and direct healthcare expenditures (http://www.sctobacco.org/policy/smokingeconomicimpactonsc.aspx).

On the day of the Great American Smokeout, why are an anesthesiologist and a surgeon writing about this topic? The answer is that help is available, and while many readers may not become patients in a hospital setting, we know that surgery and admission to a hospital (whatever the reason may be) represent a “window of opportunity” to kick the habit for many people who have the desire to do so.

First, Medicaid and many insurance companies offer partial or full coverage for tobacco dependence treatment. In South Carolina, Medicaid pays for two medications that are useful in helping patients quit. Patients having surgery and anticipating a hospitalization can be prescribed a nicotine patch during their stay and entered into a treatment program coordinated by members of the hospital staff with expertise in addiction therapy.

Second, as physicians we are the first to admit that a pill or medication isn’t the simple solution to every medical problem. Studies consistently demonstrate that a multi-layered approach to smoking cessation, including counseling or the use of “quitlines,” contributes to a higher success rate than a single intervention alone. Data indicates that only 0.4 percent of smokers in South Carolina use the assistance of a quitline when attempting to kick the habit — ranking us 50th in the nation for seeking such assistance.

What is a quitline and how can you find one? A quitline is a smoking cessation service that is available through a toll-free number. Every state in the country has a dedicated quitline, and by calling 1-800-QUIT-NOW, you will be routed to South Carolina’s quitline where you can gain access to trained coaches who provide information and help for cessation efforts. They can help with development of specific plans, discuss strategies that may work best for different types of people, and best of all, the service is absolutely free.

We know that smoking and surgery are a dangerous combination. Smokers suffer a higher incidence of surgical wound infections post-operatively, they encounter higher risks related to the administration of anesthesia in the operating room environment, and they are more likely to be admitted to the Intensive Care Unit while suffering any number of smoking-related complications after a surgical procedure.

Studies suggest that smoking cessation even within 24 hours of a procedure can begin to reduce some of these risks. And long-term cessation, of course, can have an enormous impact on health, well-being, and longevity.

Today we ask those of you who are taking the time to read this column to take a step. If you are a smoker, consider calling a quitline and beginning the process of kicking the habit for good. If you know someone who smokes, pass along this column or share the phone number listed above. While no one hopes to have surgery or looks forward to a stay in the hospital, know that help is available to quit smoking before you begin such a journey. Our physician colleagues stand ready to help. It’s time to kick the habit.