Personal Statement

I am Dr John Oyston, an anesthesiologist at The Scarborough Hospital in Toronto, Canada. This web site was my idea. This is how it came about:

For years I have been frustrated when providing anesthetics to patients who smoke. Often, they are coming for surgery which they would not need if they had not smoked. Always, they are at increased risk during and after anesthesia because of their smoking. Frequently, they cause me problems which would not have happened if they were non-smokers. Smokers are more likely to return for further surgery, either because, as a result of smoking, their original operation went poorly, or because they continue to smoke and their condition worsens, so they need re-operating. Their surgery is less likely to be successful, they will heal more slowly, and they will have an increased risk of wound infections due to their smoking habit.

Part of my job as an anesthesiologist is to ensure patients are in the best possible condition before surgery. After reviewing the evidence related to smoking and anesthesia, I realized that if I don’t do all I can to get them to stop smoking before surgery, I have not achieved this goal. I started to do research to find out what I could do. I learned that even a very brief intervention helps stop some people smoking. Sometimes it is enough for a doctor to say: “I notice that you are a smoker. I am concerned about that, as it increases the risk associated with your upcoming surgery. I think you should quit.” Also, I became aware of various web sites and toll-free numbers where patients could get assistance to “STOP SMOKING for SAFER SURGERY”.

I am not an expert on quitting smoking, and I don’t have the time or expertise to help patients quit, so I was delighted to find that there are good resources which will be able to help them. I prepared a handout for patients who are booked for surgery, explaining why they should stop smoking before surgery and remain smoke-free afterwards. To provide them with a place to go for more information, and to make my handout available to other anesthesiologists, I created this web site.

In order to make the web site look as professional as possible, and to get the message out to as many smokers as possible, I worked with Ontario’s Anesthesiologists. They encouraged me to use their resources, such as their public relations advisers, Navigator, to help improve and promote the web site and the related educational materials. I am very grateful to them for their support.

I’d like to be able to say I undertook this work because I wanted to make the world a better place, and to increase safety for my patients. But in fact a lot of my motivation is sheer laziness – I’d like to have an easier life.

Patients who smoke cause me problems. They cough and splutter in the recovery room, keeping me away from my coffee break. They have high blood pressure and abnormal ECGs, so I end up having to call cardiology for advice.

Even if they leave hospital without problems this time, I know they will be coming back, probably with worse COPD and more coronary artery disease, often for more major surgery on their blood vessels or lungs. I don’t need that hassle. I’d like them to stop smoking before the first time they come for surgery.

So, if none of the other arguments about stopping smoking get to you, how about this one: Do it so your anesthesiologist can have a quiet life.

Thanks

Dr John Oyston, BMed Sci, MB BS, FRCA
Chief, Department of Anesthesiology
The Scarborough Hospital (General Site)