Surgery as a teachable moment for smoking cessation.

TitleSurgery as a teachable moment for smoking cessation.
Publication TypeJournal Article
Year of Publication2010
AuthorsShi, Y, Warner, DO
Date Published2010 Jan
ISSN Number1528-1175
Call Numbernewpubs20100129_Shi-Warner.pdf
KeywordsAged, Aged, 80 and over, Ambulatory Surgical Procedures, Analysis of Variance, Cohort Studies, Female, Follow-Up Studies, General Surgery, Humans, Longitudinal Studies, Male, Middle Aged, Patient Education as Topic, Regression Analysis, Smoking cessation, Treatment Outcome, United States

BACKGROUND: A "teachable moment" is an event that motivates spontaneous behavior change. Some evidence suggests that major surgery for a smoking-related illness can serve as a teachable moment for smoking cessation. This study tested the hypotheses that surgery increases the likelihood of smoking cessation and that cessation is more likely after major surgical procedures compared with outpatient surgery.

METHODS: Secondary analyses were performed of longitudinal biennial survey data (1992-2004) from the nationally representative Health and Retirement Study of U.S. adults older than 50 yr, determining the relationship between the incidence of smoking cessation and the occurrence of surgery.

RESULTS: Five thousand four hundred ninety-eight individuals reported current smoking at enrollment, and 2,444 of them (44.5%) quit smoking during the period of examination. The incidence of quitting in smokers undergoing major surgery was 20.6/100 person-years of follow-up and 10.2/100 person-years in those undergoing outpatient surgery. In a multivariate negative binomial regression model, the incidence rate ratio of quitting associated with major surgery was 2.02 (95% CI: 1.67-2.44) and that of those associated with outpatient surgery was 1.28 (95% CI: 1.09-1.50). Estimates derived from national surgical utilization data show that approximately 8% of all quit events in the United States annually can be attributed to the surgical procedures analyzed.

CONCLUSIONS: Undergoing surgery is associated with an increased likelihood of smoking cessation in the older U.S. population. Cessation is more likely in association with major procedures compared with outpatient surgery. These data support the concept that surgery is a teachable moment for smoking cessation.

User Guide Notes

Endnote Keywords

Smoking/Smoking Cessation

Endnote ID


Alternate JournalAnesthesiology
Citation Key7433
PubMed ID19996946
Grant ListU01AG009740 / AG / NIA NIH HHS / United States