Background and purpose: Smoking is a risk factor for the onset of postoperative complications. Although it is thought that surgeons should provide explanations to patients on the significance of quitting smoking prior to surgery and that smoking cessation outpatient programs should be introduced, the response so far has been insufficient. The attitudes of surgeons regarding preoperative cessation of smoking also remain unclear. Here we report the results of a questionnaire survey on the preoperative cessation of smoking conducted on surgeons who regularly perform surgery under general anesthesia. This survey was conducted to investigate the attitudes of surgeons affiliated with the National Hospital Association on preoperative cessation of smoking.
Subjects and methods: The National Hospital Association comprises 143 affiliated medical facilities. We conducted an anonymous, voluntary, web-based questionnaire survey on surgeons affiliated with 90 of these facilities, excluding our own facility.
Results: Responses were received from 60 surgeons. Thirty-eight (63.3%) surgeons were affiliated with cancer treatment core hospitals and 48 (80% ) were gastroenterologists. The average annual number of surgeries performed per surgeon was 100. Twenty-eight (46.6%) surgeons responded that their affiliated facility had an outpatient smoking cessation program. The percentage of smokers among surgery outpatients was 34.2%. Fiftyeight (96.7%) surgeons responded that they recommended their outpatients to quit smoking prior to surgery. All respondent surgeons indicated that they were aware that smoking is a risk factor for postoperative complications. However, eight (13.3%) surgeons indicated that they only provided outpatient consultations on smoking cessation and 39 (65% ) responded that they did not know about the Guideline for Perioperative Smoking Cessation published by the Safety Committee of Japanese Society of Anesthesiologists.
Conclusions: The smoking rate among patients undergoing medical examinations is high, and although there is awareness regarding the necessity to quit smoking during the perioperative period, only 13.3% of surgeons reported referring patients to outpatient smoking cessation programs. The results of this study suggest that this is because of the insufficient availability of outpatient smoking cessation programs and the low degree of recognition of perioperative smoking cessation therapies.

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