Prevalence, trends and outcomes from smoking in elective surgical systems: a secondary analysis of a prospective observational cohort study across 442 hospitals from 29 countries across Europe

作者：Sivesh K. Kamarajah, Ieva Jakaityte, Shengli Yang, Omar Kouli, Kariem El‐Boghdadly, Amanda B. Farley, James Glasbey, Dion Morton, Krishnarajah Nirantharakumar, Thomas Pinkney, David Thickett, Joyce Yeung, Aneel Bhangu, Dmitri Nepogodiev · 发表于：The Lancet Regional Health - Europe · 年份：2025 · DOI：10.1016/j.lanepe.2025.101282 · 被引用次数：5 · 研究领域：COVID-19 and healthcare impacts、Cardiac, Anesthesia and Surgical Outcomes、Smoking Behavior and Cessation

Background: Smoking remains a significant public health issue in Europe, with elective surgery offering a key opportunity for intervention. Knowledge gaps exist around its prevalence and the optimal timing for preoperative cessation to improve outcomes, despite current guidelines recommend smoking cessation up to six weeks prior to surgery. This study aims to address this gap in a large observational prospective cohort study of patients undergoing abdominal surgery across Europe. Methods: We performed a pre-planned secondary analysis of a prospective, international cohort study of patients undergoing elective abdominal surgery between January 24, and May 03, 2022. The primary measure was smoking status and secondary measures were prevalence by age, gender, and number of long-term conditions. Multilevel logistic regression was used to explain the relationship between preoperative smoking status on postoperative overall (primary outcome) and major (secondary outcome) complications. Three-level models were constructed with patients nested within hospitals and countries. Findings: 16,327 patients from 442 hospitals across 29 countries were included. 3179 patients (19.5%, 95% confidence interval (CI): 18.9%-20.1%) were current smokers, ranging from 8.3% to 31.7% across the included countries. Rates of current smokers were higher in younger patients (18-40 vs 41-60 vs 61-80 vs ≥ 81 years: 26.8% [95% CI: 24.8%-28.9%] vs 25.3% [95% CI: 24.2%-26.4%] vs 15.1% [95% CI: 14.3%-16.0%] vs 5...