How one facility helps patients stop smoking

Interventions offered before elective surgery

The University of California — San Francisco (UCSF) Medical Center uses a variety of interventions to help patients stop or reduce smoking before elective surgery.

In the outpatient setting, patients are referred to an in-hospital smoking cessation leadership program, tobacco education center, and a habit abatement center. "The goal is to facilitate the referral of active smokers to these resources, which offer inexpensive smoking cessation counseling, social support, and guide the use of cessation medication," says John Maa, MD, FACS, assistant professor in the Department of Surgery and assistant chair, Surgery Quality Improvement Program, UCSF.

As a first step, surgery patients are directed to smoking cessation quitlines through a national toll-free number (800-QUIT-NOW), Maa says. "They are also evaluated for immediate intervention with nicotine replacement therapy prescribed by the surgeon, which can be further coordinated with their referring primary care provider," he says.

Before most surgeries, patients are seen in the Prepare (pre-anesthesia) clinic. "The anesthesiologists or nurse practitioners will remind the patient of the benefits of preoperative smoking cessation, and again offer the resources of quitlines, the habit abatement clinic, or other measures to assist in smoking reduction," Maa says.