A Discussion about Modalities of Smoking Cessation in Perioperative Phase for Addicts: A Review Article

Cigarette smoking is a worldwide healthcare problem of modern age. It is a leading cause of death, mainly in male population. Excess deaths among smokers, as compared to non smokers, are chiefly due to tuberculosis and respiratory, cardiovascular or malignant diseases. Smoking significantly increases intraoperative and postoperative complications in a person undergoing surgical procedure. Smoking is menace to people and physicians and cessation of smoking is very much desirable, especially in persons undergoing operative intervention. Smoking cessation prior to the operation has been traditionally advised to be for 6 weeks but such an endeavour may have unwanted consequences because of withdrawal symptoms. Hence it is necessary that smoking cessation is achieved with minimal consequences so that the operative procedure can be conducted with minimal problems. Smoking cessation for a current user needs an active approach and provision of support for a cessation attempt. A combination of pharmacotherapy with behavioral interventions provides the best results. Available treatment modalities are nicotine replacement therapy and non-nicotine therapies such as bupropion, nortriptyline and varenicline. The most commonly used drugs are varenicline and bupropion. The focus of this article is on partial selective nicotine receptor agonist drug varenicline. By comparing different studies and researches worldwide, we showed in this article that varenicline provides the most sustaining and cost effective result. It also has less cardiovascular and respiratory side effects than nicotine replacement therapy and bupropion. The only limiting side effect may be psychiatric side effects including depression, self harm and suicidal tendencies, though they warrant further investigation and research.