Letter to the Editor

New research on smoking

I'd like to relay a new medical research article titled "Smoking and Perioperative Outcomes" on smoking and anesthesia from the April 2011 edition of Anesthesiology. One hundred sixty-four thousand patients were matched with never smokers and here are the results and conclusions from the researchers on this new data:The tobacco epidemic represents a significant preventable cause of death and is probably the greatest health disaster in human history, being associated with more than 5 million deaths worldwide annually, and in the 20th century killing more than 100 million people. Tobacco dependence is also arguably the most difficult dependency to break and often requires repeated interventions and attempts to quit. A mounting body of evidence has led to the following two important conclusions: 1) Smoking harms nearly every organ in the body, causing many diseases and reducing smokers' general health. 2) Quitting smoking has long-term benefits by reducing risks for diseases caused by smoking.

In the United States currently 443,000 deaths a year are related to smoking, costing approximately $157 billion in annual health-related economic losses.

During the perioperative period, smokers are 1.38 times more likely to die than never smokers. Pneumonia is 2.09 times more likely, unplanned intubations 1.87 times, mechanical ventilation 1.53 times, cardiac arrest 1.57 times, myocardial infarction 1.80 times, and stroke 1.73 times more likely. Infection is 1.42 times, and septic shock 1.55 times more likely to occur. These higher complication rates and 30-day mortality rates should help motivate smoking cessation in surgical patients.

DR. ANDREW WALKER, anesthesiologist, Cape Girardeau