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ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

Anesthesiologists, General Surgeons, and Tobacco Interventions in the Perioperative Period

David O. Warner, MD^*, Michael G. Sarr, MD, Kenneth P. Offord, MS, and Lowell C. Dale, MD

Departments of *Anesthesiology, Surgery, Medicine, and Health Sciences Research, Mayo Clinic, Rochester, Minnesota

Address correspondence and reprint requests to David O. Warner, MD, Department of Anesthesiology, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905. Address e-mail to warner.david{at}mayo.edu

Surgery presents an opportunity for interventions in cigarette smokers that will facilitate abstinence from tobacco. However, little attention has been paid to the role of anesthesiologists and surgeons in addressing tobacco use. To determine the practices and attitudes of these physicians regarding this issue, we sent a postal mail survey to a national random sampling of anesthesiologists and general surgeons engaged in active practice within the United States (1000 in each group). Response rates were 33% and 31% for anesthesiologists and surgeons, respectively. More than 90% of both groups almost always ask their patients about tobacco use, and almost all respondents believed that surgical patients should maintain abstinence after surgery. Most believed that it was their responsibility to advise their patients to quit smoking, but only 30% of anesthesiologists and 58% of surgeons routinely do so. Nonetheless, approximately 70% of both groups would be willing to spend an extra 5 min before surgery to help their patients quit. Barriers to intervention included a lack of training regarding intervention techniques, a perceived lack of effective interventions, and insufficient time to intervene. Intervention opportunities are not exploited consistently in the surgical population; educational efforts directed at physicians in surgical specialties are indicated.

IMPLICATIONS: Although most surgeons and anesthesiologists believe that it is important for their patients to stop smoking at the time of surgery, most do not have the knowledge or experience to help them achieve this goal.

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