Smoke Ban on Patients Having Operation

Surgeons should be allowed to say no to operate on a smoker, according to a new proposal from the Swedish National Board of Health and Welfare.

Smokers have a higher risk of complications after an operation, and therefore the Board wants to make it possible for doctors to demand that a patient refrains from smoking before the operation and some weeks after.

When a smoker has an operation, even a smaller straightforward surgery, he or she has a higher risk of getting infections, blood clots and that the healing is slower.

This is something we should try to avoid, says Lars-Erik Holm, who is the director-general of the Swedish National Board of Health and Welfare.

"Today we see that 8-9 percent of people in hospitals are there due to complications after operations or injuries that they have received while in health care. Therefore it is important we do all we can to lower these complications, and a smoking ban is an important part of that," says Lars-Erik Holm.

It is not a question of punishing the smoker, or demanding that he or she stops smoking for the rest of his or her life, says Holm. Instead it is about offering a qualified anti-smoking programme so that the patient can be smoke free by the operation and a few weeks after that. What the patient does after that is up to each individual.

But can you really decline health care to a patient just because he or she is a smoker?

"At the end of the day it is up to the patient to decide, but the fact is that it is not a right to have an operation. The medical judgement is made by doctors, who at the moment can tell a patient that "you have to fast" before the operation.

"If the patient does not want to do that, it might be very hard to operate, because risk for serious complications increases. It is also important to control the blood pressure so a doctor can tell the patient "you have to loose a few kilos for us to be able to operate.

"These kinds of judgements are already made today, but we have allowed the smoking to be a no-go area and it is time to realise that smoking is the biggest health-problem for Swedes today," says Lars-Erik Holm, at the National Board for Health and Welfare.