Smoking and postoperative pulmonary complications - An evidence-based review of the recent literature

Postoperative pulmonary complications (PPC) lead to significant morbidity a fter both thoracic and non-thoracic surgical procedures. The role of smokin g as an independent risk factor is controversial, though recent level III a nd IV studies suggest that it may indeed be significant. In addition, the r ole and timing of pre-operative smoking cessation is not clear. Although so me studies suggest that abstinence too soon prior to operation may actually increase the risk of PPC, it still appears that aggressive counseling for smoking cessation prior to any elective procedure is the best overall cours e of action.