Stopping smoking

After cessation of smoking 20 cigarettes a day for 20 years, which one of the following takes the LONGEST to show signs of significant improvement?

a) Small airway function

b) The negative inotropic effect of smoking

c) Excess sputum production

d) Polycythaemia

e) Risk of chest infection

Answer: e

Explanation

Stopping smoking 12 hours before surgery significantly reduces the level of  carboxyhaemoglobin, increases oxygen carrying capacity of blood, and reduces the negative inotropic and arrhythmic effects of smoking. Stopping smoking for 12 to 24 hours will reduce elevated heart rate and blood pressure, and improve peripheral vasoconstriction. Stopping smoking for a week will improve raised blood viscosity and polycythaemia. Stopping smoking for one month improves small airway function, which continues to improve for a further six months. Stopping smoking for six weeks will produce gains in reducing excess sputum production, with a 50% reduction in the first two weeks. Stopping smoking for two months reduces the risk of postoperative chest infection with a risk approaching that of non-smokers if the patient stops for six months. The longer the period of abstinence, the less likely a wound complication.

Reference

Doctors and Tobacco. The Tobacco Control Resource Centre website. Online at www.

tobacco-control.org/ (Accessed 30 October 2009)