Smoking is a public health problem of particular importance during the perioperative period, since it exposes patients scheduled for surgery to risk increases of 20% in hospital mortality and 40% in major postoperative complications. In addition, current smoking increases almost all specific surgical complications. The perioperative period offers a genuine opportunity for smoking cessation. The rate of preoperative smoking cessation can be increased significantly by offering behavior management and the prescription of a nicotine substitute before any scheduled surgical intervention. Preoperative smoking cessation should be routinely recommended independently of the timing of the intervention, even though the benefits increase in proportion with the length of cessation. All professionals of the care pathway (general practitioners, surgeons, anesthetists-intensivists, caregivers) must inform smokers of the positive effects of smoking cessation and offer them dedicated management and personalized follow-up. In children, cessation of parental smoking or removal of the child from environmental tobacco smoke as long before surgery as possible is indispensable.

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BackgroundTo evaluate the public health efficacy of a community-based smoking cessation program (TABADO) among vocational school trainees (15 to 20 years old).MethodsThis prospective, controlled, quasi-experimental study was conducted in eight vocational training centres (VTC) in France. The intervention group underwent the TABADO program, which included a general information session for all students and small-group sessions plus individual counselling and nicotine therapy, if needed, for volunteers in an enhanced program. The control group received no specific intervention other than the educational services usually available. The primary outcome was 30-day point prevalence abstinence at 12 months.ResultsThe mean age of the 1,814 students included was 16.9 years (SD = 1.0); 84.7% were males. At baseline, 52% were smokers and 5.7% ex-smokers. In the intervention group, 24.6% of smokers volunteered for the enhanced program and 18.1% could be included. By 12-month follow-up, with participants lost to follow-up considered non-abstinent, 10.6% of smokers in the intervention group had become abstinent versus 7.4% in the control group (adjusted p = 0.03; odds ratio [OR] = 1.8; 95% confidence interval [CI] = 1.05–3.0); considering lost to follow-up as missing data, 17% of intervention group participants were abstinent versus 11.9% in the control group (univariate p = 0.08; adjusted p = 0.008; OR = 2.1; 95% CI = 1.2–3.6).ConclusionThe TABADO program, targeting teenagers in vocational schools, was effective in producing a higher 12-month abstinence rate among all smokers in the intervention group.Trial registrationClinical trial identification number is NTC00973570.

The majority of IBD patients are unaware of the effects of tobacco on their disease. Better information through a therapeutic education programme should be systematically recommended in IBD.

Background: Tobacco smoking is associated with more severe asthma symptoms, an accelerated decline in lung function, and reduced responses to corticosteroids. Our objective was to compare asthma outcomes in terms of disease control, exacerbation rates, and lung function in a population of asthmatic patients according to their smoking status. Methods: We compared patients’ demographics, disease characteristics, and lung-function parameters in current-smokers (CS, n = 48), former-smokers (FS, n = 38), and never-smokers (NS, n = 90), and identified predictive factors for asthma control. Results: CS had a higher prevalence of family asthma/atopy, a lower rate of controlled asthma, impaired perception of dyspnea, an increased number of exacerbations, and poorer lung function compared to NS. The mean asthma control questionnaire’s (ACQ) score was higher in CS vs. NS and FS (1.9 vs. 1.2, p = 0.02). Compared to CS, FS had a lower rate of exacerbations, a better ACQ score (similar to NS), a higher prevalence of dyspnea, and greater lung-diffusion capacity. Non-smoking status, the absence of dyspnea and exacerbations, and a forced expiratory volume in one second ≥80% of predicted were associated with controlled asthma. Conclusions: CS with asthma exhibit worse clinical and functional respiratory outcomes compared to NS and FS, supporting the importance of smoking cessation in this population.