Smoking Cessation

This chapter presents the case scenario of a 27-year-old female with a history of depression and tobacco abuse presents to the Emergency Department after falling off a ladder at home. She asks what she can do to improve her chances of walking again and whether she should stop smoking. To improve patient outcomes in orthopedics, it is critical to understand which reversible factors may predispose to poor outcome. Smoking has been associated with increased risk for postoperative wound complication and infection across all surgical subspecialties. A meta-analysis of randomized trials evaluated the effect of smoking cessation on postoperative complications across a range of surgical subspecialties. Despite the well-recognized negative impact of smoking on orthopedic patients, there is surprisingly little evidence supporting modalities affecting smoking cessation. Orthopedic surgeons can play an important role in smoking cessation by offering education, support, and encouragement. The chapter also provides recommendations for implementing evidence-based practice in the clinical setting.