Surgery patients who are smokers experience higher rates of intraoperative blood loss, greater need for intraoperative transfusions, higher rates of postoperative complications, and, in some patients with cranial cancer, shorter survival times, according to scientists from University of California, San Francisco and Yale University School of Medicine. The study results were published online ahead of print in the Journal of Neurosurgery.

In a review of published surgical reports, a small number of which specifically focused on neurosurgical procedures, researchers discovered strong reasons for neurosurgeons to urge their patients to quit smoking prior to surgery and to encourage nationwide efforts to promote smoking cessation before surgical procedures. “There is limited but good evidence that smoking is associated with higher rates of perioperative complications following neurosurgical intervention,” wrote the authors.

Investigators organized their findings according the three major types of neurosurgical procedures: cranial, spinal, and peripheral nerve surgeries. They found evidence that smoking cessation can reduce the higher risk of perioperative complications seen in active smokers and recommended that neurosurgeons promote cessation.

“Because one of the most powerful times to convince a smoker to quit is before a surgical procedure, neurosurgeons are encouraged to do so. On the policy level, neurosurgeons should take the lead in catalyzing constructive changes to minimize the impact of tobacco smoking in the perioperative setting,” the authors concluded.