Monitoring of Exhaled Carbon Monoxide to Promote Pre-operative Smoking Cessation

Smoking causes 90% of all lung cancer deaths among men and 80% of lung cancer deaths in
women. Surgery is a great opportunity to help patients quit smoking. Smokers are at
increased risk for heart, lung, and wound complications around the time of surgery. Even a
brief abstinence from smoking can produce benefits. Surgery can also motivate smokers to
quit spontaneously. If the investigators can take advantage of this great opportunity, they
may be able to help many smokers quit using simple means. However, currently most smokers
continue to smoke cigarette on the morning before surgery, as shown by the measurement of
exhaled carbon monoxide (CO) on the morning of surgery. CO is one of the many poisons in
cigarette smoke. It only stays in the body for a few hours. By asking smokers to blow into
a small machine, the investigators can test the CO level in the smokers' body and thus know
if they have just smoked within the past few hours. The goal of this study is to determine
the role of carbon monoxide monitoring as a means to decrease cigarette smoking before
surgery. The investigators will identify a group of smokers who are scheduled for surgery
and invite them to participate. One or two days before surgery, half of the patients will
receive a brief advice about quit smoking. The other half of patients will be told that
their CO will be checked before surgery, in addition to the brief advice. On the morning of
surgery, the investigators will then check their CO level to determine if they have followed
the advice. In order to have a better understanding about the factors influencing patients'
intent to quit smoking, the investigators will ask all study participants to fill out a
questionnaire. The questionnaire is constructed according to behavioral theories which
provide good framework for studying people's intent and behavior. If the investigators are
successful, they will determine how much of an impact the message of CO testing has on
smoking before surgery. The investigators will also gain insights into facilitators and
barriers to smoking cessation around the time of surgery. The brief intervention evaluated
in this study has potential to be disseminated and to promote the long term health of
surgical patients.