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Compared with never smokers, health care costs during the first year after hospital discharge for an inpatient surgical procedure are higher in both former and current smokers. Warner DO, Borah BJ, Moriarty J, Schroeder DR, Shi Y, Shah ND. Smoking status and health care costs in the perioperative period: a population-based study. JAMA Surg. 2014 Mar;149(3):259-66.


Personalized smoking cessation advice and support by mobile phone message is both beneficial for health and cost saving to a health system. Guerriero C, Cairns J, Roberts I, Rodgers A, Whittaker R, Free C.The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop. Eur J Health Econ. 2013 Oct;14(5):789-97.


Smokers had significantly annual higher health care costs than nonsmokers ($1274). Moriarty JP, Branda ME, Olsen KD, Shah ND, Borah BJ, Wagie AE, Egginton JS, Naessens JM.  The effects of incremental costs of smoking and obesity on health care costs among adults: a 7-year longitudinal study. J Occup Environ Med. 2012 Mar;54(3):286-91.


Prior and current smoking status is a significant risk factor for major postoperative complications and mortality following GI cancer and thoracic operations in veteransGajdos C, Hawn MT, Campagna EJ, Henderson WG, Singh JA, Houston T. Adverse effects of smoking on postoperative outcomes in cancer patients. Ann Surg Oncol. 2012 May;19(5):1430-8


Smoking cessation therapy does not raise short-term healthcare costs. By the sixth quarter post-quit, sustained quitters were less costly than trial participants who continued smokingHockenberry JM, Curry SJ, Fishman PA, Baker TB, Fraser DL, Cisler RA, Jackson TC, Fiore MC. Healthcare costs around the time of smoking cessation. Am J Prev Med. 2012 Jun;42(6):596-601.


Current smokers had significantly higher costs compared with never smokers; the relationship between smoking and hospital costs for current smokers was partially mediated by postoperative respiratory complications. Kamath AS, Vaughan Sarrazin M, Vander Weg MW, Cai X, Cullen J, Katz DA. Hospital costs associated with smoking in veterans undergoing general surgery. J Am Coll Surg. 2012 Jun;214(6):901-8.


Lower physical distress tolerance could place female smokers at risk for difficulty in quitting smokingPulvers K, Hood A, Limas EF, Thomas MD. Female smokers show lower pain tolerance in a physical distress task. Addict Behav. 2012 Oct;37(10):1167-70.


Longer periods of smoking cessation decrease the incidence of postoperative complicationsMills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011 Feb;124(2):144-154


Smoking cessation was not independently associated with changes in pain symptoms in older adultsYu Shi, WM Hooten, DO Warner. Effects of Smoking Cessation on Pain in Older Adults. Nicotine Tob Res. 2011 Oct; 13(10): 919–925. 


Current smoking at the time of surgery is associated with a poor postoperative quality of lifeBalduyck B, Sardari Nia P, Cogen A, Dockx Y, Lauwers P, Hendriks J, Van Schil P. The effect of smoking cessation on quality of life after lung cancer surgery. Eur J Cardiothorac Surg. 2011 Dec;40(6):1432-7.


Compared with both never and prior smokers, current smokers had significantly more postoperative pneumonia, surgical-site infection, and deaths, with a dose-dependent increase in pulmonary complications based on pack-year exposureHawn MT, Houston TK, Campagna EJ, Graham LA, Singh J, Bishop M, Henderson WG. The attributable risk of smoking on surgical complications. Ann Surg. 2011 Dec;254(6):914-20


Tobacco users have significantly lower risk of post-operative nausea and vomiting. Brattwall M, Warrén Stomberg M, Rawal N, Segerdahl M, Houltz E, Jakobsson J. Postoperative impact of regular tobacco use, smoking or snuffing, a prospective multi-center study. Acta Anaesthesiol Scand. 2010 Mar;54(3):321-7.


Economic analysis shows that a preoperative smoking intervention program is beneficial to society and the patient alikeMøller AM, Kjellberg J, Pedersen T. [Health economic analysis of smoking cessation prior to surgery--based on a randomised trial]. Ugeskr Laeger. 2006 Mar 6;168(10):1026-30.


Longer periods of smoking cessation appear to be more effective in reducing the risk of postoperative complications; there was no increased risk in postoperative complications from short term cessationTheadom A, Cropley M.Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. Tob Control. 2006 Oct;15(5):352-8.


Routine nicotine replacement therapy is not indicated in smokers undergoing surgery for the purposes of managing nicotine withdrawal and stress but can modify some aspects of postoperative smoking behaviorWarner DO, Patten CA, Ames SC, Offord KP, Schroeder DR: Effect of nicotine replacement therapy on stress and smoking behavior in surgical patients. Anesthesiology 2005; 102:1138–46


Treatment with a single dose of nicotine immediately before emergence from anesthesia was associated with significantly lower reported pain scores during the first day after surgery. The decreased pain was associated with a reduction in morphine utilization and the analgesic effect of nicotine was not associated with hypertension or tachycardiaFlood P, Daniel D: Intranasal nicotine for postoperative pain treatment. Anesthesiology 2004; 101:1417–21


Longer periods of smoking cessation appear to be more effective in reducing the incidence/risk of postoperative complications; there was no increased risk in postoperative complications from short term cessationMoller AM, Pedersen T, Villebro N, Norgaard P: Impact of lifestyle on perioperative smoking cessation and postoperative complication rate. Prev Med 2003; 36:704–9


Short-term cessation of smoking does not reduce the risk of complicated tissue in colorectal surgerySorensen LT, Jorgensen T: Short-term pre-operative smoking cessation intervention does not affect postoperative complications in colorectal surgery: A randomized clinical trial. Colorect Dis 2003; 5:347–52


Smoking is a significant predictor of severe cardiovascular and respiratory outcomes in the perioperative period. Forrest JB, Rehder K, Cahalan MK, Goldsmith CH. Multicenter study of general anesthesia. III. Predictors of severe perioperative adverse outcomes. Anesthesiology. 1992 Jan;76(1):3-15.