American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Smoking Cessation and the Surgical Patient

Guests: Eric Skipper, MD, FACS, chief of adult cardiothoracic surgery at the Sanger Heart & Vascular Institute, Charlotte, NC, and Michael Rosen, MD, FACS, professor of surgery and chief of GI and general surgery at Case Western Reserve University, Cleveland, OH.

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It has been 50 years since the surgeon general first issued a landmark report on the risks of smoking cigarettes, and much has been done since that time to decrease smoking rates. However, one in five adults still smoke, and this habit can have negative effects if a smoker undergoes an operation.

What are the risks for surgical patients who smoke cigarettes? Is quitting cold turkey the best option? Should patients be tested for nicotine prior to having an operation? In this episode of The Recovery Room, host Dr. Rick Greene speaks with two experts, Eric Skipper, MD, FACS, and Michael Rosen, MD, FACS, about their experiences in working with surgical patients who smoke.

“Certainly the longer you quit smoking the better effects you are going to have and more of a benefit to quitting smoking,” said Dr. Rosen. He noted that there are both short-term and long-term benefits to smoking cessation prior to an operation.

Dr. Skipper said that testing patients for nicotine in their system is not as common as it would ideally be. “In the average practice of medicine out there, there’s probably an overall lack of testing,” said Dr. Skipper. “One venue in which we do test is in the transplant arena because how patients do after transplant is so key to these behaviors that one of the things that rule you out for transplant is continued smoking.”


Dr. Skipper is chief of adult cardiothoracic surgery at the Sanger Heart & Vascular Institute, Charlotte, NC.  His surgical specialties are cardiovascular surgery and thoracic surgery.

Dr. Rosen is professor of surgery and chief of GI and general surgery at Case Western Reserve University, Cleveland, OH. He has special interests in gastrointestinal surgery, gastrointestinal cancer, hernia surgery, laparoscopic and minimally invasive surgery, and upper gastrointestinal cancer.