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Smoking CessaTion
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Smoking Cessation

Most smokers know cigarettes can damage their lungs, but all too often, they have no idea that smoking is also bad for their blood vessels.

For too many smokers, the first they learn of the connection is when a vascular surgeon diagnoses them with peripheral artery disease (PAD). The disease starts mildly with either no symptoms at all, or with leg pains when walking. If the patient continues poor lifestyle habits, like smoking, PAD slowly starves the toes, feet and legs (peripheral parts of the body) of oxygen, which can lead to gangrene and amputation if not treated.

Here are three ways that cigarette smoke damages blood vessels:

  • Nicotine is a stimulant, which speeds up the heart by about 20 beats per minute with every cigarette. It raises blood pressure and is a vasoconstrictor, which means it makes arteries all over the body become smaller. That makes it harder for the heart to pump blood through the constricted arteries and it causes the body to release its stores of fat and cholesterol into the blood.
  • Smoking accelerates the hardening and narrowing process in arteries. Stiff, narrowed arteries are common in elderly people, but for smokers that process starts earlier, effectively giving them “old” arteries.
  • It increases “bad” cholesterol (low-density lipoprotein) and decreases the “good” cholesterol (high-density).

“Getting our patients to quit smoking is probably the most important thing we can do, probably even more than any surgery we would talk about,” said Dr. Matthew Edwards, a vascular surgeon with Wake Forest University School of Medicine. The majority of his vascular patients will think about quitting when faced with their vascular disease, he said, but at least a third have no interest.

Research has shown that smokers have far more surgical complications, and many surgeons are reluctant to operate on them unless it’s an emergency. Smoking cessation before surgery is recommended by the Society for Vascular Surgery and the American College of Cardiology among others.

Physician resources

Physician resources for patients




“Smoking cessation is a critical issue for the vascular surgery population. Focusing the power of the VQI on this important issue is one of the most important things we can do to improve our patient outcomes and their quality of life. I am proud to be part of a forward thinking organization that understands this and is willing to make smoking cessation resources for vascular surgeons and their patients a reality.”

Dr. Samantha Minc
WVU Medicine

New Reporting Measures

For the Spring 2023 reporting cycle, two new measures were added in anticipation of the new National Quality Initiative of Smoking Cessation.

Preop Smoking

Includes elective CAS (TFEM CAS and TCAR), CEA, EVAR, INFRA, LEAMP, OAAA, PVI, SUPRA, and TEVAR procedures only.

Preop Smoking is the number of procedures meeting the inclusion criteria, and the percentage of those procedures where the patient was still smoking within one month of the procedure.

Smoking Cessation

Includes CAS (TFEM CAS and TCAR), CEA, EVAR, HDA, INFRA, LEAMP, OAAA, PVI, SUPRA, and TEVAR procedures performed on patients still smoking within one month of the procedure. Excludes procedures that do not have at least one long-term follow-up record where the patient’s follow-up smoking status was recorded.

Smoking Cessation is the number of procedures meeting the inclusion criteria, and the percentage of those procedures where the patient was not smoking within one month on follow-up for all long term follow-up records where the patients follow-up smoking status was recorded.