Smoking, Orthopedic Surgery, and Bone Healing

When assessing a smoker who is scheduled for surgery, most of us will quickly zero in on their potential for complications from anesthesia. But what if the upcoming procedure is orthopedic?

Smoking is a well-known risk factor for osteoporosis and bone fracture, so it makes sense that it can be an issue in bone surgery healing.

In “The Effects of Smoking on Bone Health and Healing” in this month’s AJN, authors Stephanie Niu and Fidelindo Lim review the effects of smoking on bone health and healing and offer suggestions on how nurses might use this information to help people facing orthopedic surgery to quit.

“In addition to posing surgical and postsurgical risks for orthopedic patients, tobacco, nicotine, and other byproducts contained in traditional and electronic cigarettes (e-cigarettes or vaping products) adversely affect overall bone health and impede bone healing.”

Smoking associated with poor postsurgical outcomes.

Research has shown that smoking is associated with postop infection and poor bone fusion. It significantly increases time to union and risk of nonunion, and is significantly associated with poor clinical outcomes after surgery. […]

2020-07-20T09:16:45-04:00July 20th, 2020|Nursing|0 Comments
Read More

Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and […]

2017-06-21T06:42:46-04:00June 21st, 2017|Nursing, personal health practices, Public health|3 Comments
Read More

Remembering a Tough NYC Detective on the 41st Great American Smokeout

Photo of AJN editor-in-chief Shawn Kennedy AJN editor-in-chief Shawn Kennedy

My uncle Joe embodied the persona of the old-time tough NYC Irish detective—he was over six feet tall, had piercing blue eyes and white hair, always wore a tan raincoat, and always had a cigarette in his hand. As a child, my siblings and I were always a little bit afraid of him. That image faded, though, and my last image of him was hunched over, with an oxygen cannula, trying to breathe. All those cigarettes added up, and after a lifetime of smoking, he died from chronic lung disease. This was before the landmark report on smoking and health issued by the U.S. surgeon general in 1964. Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC) Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC)

Today is the 41st annual Great American Smokeout—the day created by the American Cancer Society (ACS) to help encourage smokers to quit smoking. According to […]

2016-11-21T13:00:49-05:00November 16th, 2016|Nursing, personal health practices, Public health|0 Comments
Read More

Smoking, Nurses, Knowledge: We’ve Come a Long Way, But Not Far Enough

By Shawn Kennedy, MA, RN, AJN editor-in-chief

"Smoke break"/by sylvar, via Flickr “Smoke break”/by sylvar, via Flickr

Back in the day, I remember riding in the car with my parents, both of whom smoked. My siblings and I used to jockey for the window seats so we could be near the fresh air streaming in.  And I recall holidays with visiting relatives when all the adults would sit in the living room smoking cigarettes. (Kent filter-tips for the women; Camels for the men.) And as kids, we used to “smoke” candy cigarettes. The ones that “puffed” when you blew into them were our favorites.

But I also recall getting older and not wanting to visit my Uncle Joe, a once tough New York City police detective, because he would just sit on the edge of his chair, leaning over a table and struggling to breathe. This made my dad quit cold turkey after he had a heart attack at age 48 and our family physician told him he could either keep smoking or quit and see his children get married. My mom quit when she was pregnant with my youngest sister, after the surgeon general’s report said smoking could harm the fetus.

Our parents were constantly telling us that they wished they’d never started (my […]

2018-03-28T10:27:17-04:00January 22nd, 2014|nursing perspective|3 Comments
Read More

E-Cigarettes: Positive Smoking Substitute or a New Problem Replacing the Old?

Photo by Michael Dorausch, via Flickr

By Michael Fergenson, senior editorial coordinator

The dangers of smoking cigarettes are well documented, from the terrifying commercials about what smoking does to our bodies to the warnings right on the pack. Yet the Centers for Disease Control and Prevention estimates that 45.3 million people in the United States smoke.

Now, a new trend in tobacco products has become the center of much debate. I’m referring to the electronic cigarettes, or e-cigarettes, that are gaining popularity as a smoking alternative and, for many, as a tool to quit.

I personally know two people who are using this device in an attempt to stop smoking. An article published in the New York Times last November reports that the number of Americans trying e-cigarettes “quadrupled from 2009 to 2010.” The article also cites the results of a survey published in Tobacco Control last year, which found that 1.2% of adults, or close to 3 million people, had reported using these products in the previous month. But are e-cigarettes really a positive smoking substitute and aid to quitting?

How they work. Most e-cigarettes are shaped like a real cigarette, but some have a unique look. They work by heating up a liquid—purchased […]

2017-03-10T16:53:37-05:00May 4th, 2012|Nursing|21 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top