The impact of smoking on the peri‐operative course and the effect of pre‐operative smoking intervention

[Physician's advice and treatment of smokers]

This article describes the health effects of smoking and smoking cessation. The doctor's office provides advantages for the counseling and treatment of smokers, such as continuous patient contacts, the option to address smoking in the context of smoking-related diseases, ubiquitous and low-threshold access to health care, therefore, offering equal access to lower socioeconomic classes. However, barriers exist for the implementation of smoking-related counseling in private practice due to the lack of reimbursement, insufficient qualification, lack of available time as well as lack of patients' motivation. Moreover, in the German healthcare system tobacco dependency has not yet been acknowledged as a treatment-demanding disease. Existing obstacles should be overcome by adjustment of reimbursement schemes for private practice and hospitals as well as reimbursement for smoking cessation medication proven to be effective for tobacco-dependent smokers. The German Medical Association has established a training program for doctors who want to become active in smoking cessation and has developed printed material for the counseling of smokers in private practice.