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Editor's Correspondence
Aug 8 2011

What Is a Reasonable Threshold for Worries About Health Risks?—Reply

Author Affiliations

Author Affiliations: Department of Cardiology and Sydney Medical School, Westmead Hospital Campus, University of Sydney, and The George Institute for Global Health, Sydney, New South Wales, Australia (Dr Chow); and Departments of Medicine and Clinical Epidemiology and Biostatistics (Dr Devereaux) and the Population Health Research Institute (Drs Chow and Devereaux), McMaster University, Hamilton, Ontario, Canada.

Arch Intern Med. 2011;171(15):1401-1404. doi:10.1001/archinternmed.2011.342

In reply

Myers and colleagues state that we concluded “that stopping smoking shortly before surgery is not safe after all.” This is not accurate. Our concluding comments were the following:

Given the limited amount of data (a total of 889 patients included across all studies), the methodologic limitations (eg, broad composite outcome), the substantial variations in the definitions of recent quitters, and the demonstrated heterogeneity, it is questionable whether clinicians should be reassured that the timing of smoking cessation prior to surgery does not matter. Physicians should ideally try to get their patients to stop smoking several months prior to their surgery. The appropriate advice regarding the optimal timing of smoking cessation for patients seen close to their scheduled surgery awaits further research.1(p990)

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