Evidence base and strategies for successful smoking cessation

The burden of tobacco dependence can be measured in premature deaths due to accelerated atherosclerotic disease and cancer, and economic costs of lost productivity and intensified medical care. Smoking cessation efforts have benefited from continued pharmacologic developments, increased public awareness of stop-smoking programs, aggressive counter-campaigns to illustrate the toll of cigarette smoking, and recognition of the many primary and secondary effects of smoking exposure on the general public. Vascular surgeons and interventionalists, as well as vascular medicine specialists, are uniquely positioned to engage and educate the patient to promote cessation, monitor for continued abstinence, and assist in efforts to avoid relapses. This article reviews the effects of tobacco dependence on peripheral arterial disease, perioperative considerations in smokers, as well as common clinical interventions such as counseling and pharmacotherapy to encourage tobacco cessation. (J Vasc Surg 2010;51:1529-37.)