Smoking at the time of curative-intent lung cancer surgery dramatically influences peri-operative complications

Introduction: Smoking is a risk factor for postoperative pulmonary complications (PPCs) following curative-intent surgery for lung cancer (P.Agostini et al, Thorax 2010;65:815-8). Risk modification is via smoking cessation programmes; whether surgery should be delayed for this is a debated topic. Aims & Objectives: To study the impact of smoking on postoperative outcome including long-term survival. Methods: A prospective observational study was carried out on all patients following curative-intent lung cancer resection in a regional thoracic centre over 4 years. Preoperative smoking status was self-reported by all patients. Data included patient demographics, PPCs, hospital length of stay (LOS), intensive treatment unit (ITU) admission and mortality. Results: Of 460 patients, 24% were current smokers, 12% ex-smokers 6 weeks, and 11% never smokers. Independent risk factors associated with smoking status using multivariate analysis were FEV1% predicted, COPD and BMI (p Conclusions: Preoperatively, 1 in 4 patients continue to smoke. Current smokers have higher postoperative morbidity with no significant survival difference within our short follow-up period. Further research into effective short-term smoking abstinence programmes is needed.