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Smoking Status Unclear in Plastic Surgery Candidates

Many patients may either conceal smoking status or underestimate actual smoking amount

WEDNESDAY, Nov. 29 (HealthDay News) -- Patients undergoing elective plastic surgery may often falsely report non-smoking status or underestimate the number of cigarettes they smoke, according to the results of a study published in the November issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

Caroline E. Payne, B.Sc., M.Sc., F.R.C.S., of the Department of Plastic and Reconstructive Surgery, Pinderfields Hospital in Wakefield, U.K., and colleagues asked 100 elective surgery candidates (62 women and 38 men) to complete comprehensive smoking questionnaires and then gave each of them a urine test to measure nicotine and its breakdown products such as cotinine.

The researchers found that self-reported smoking prevalence was 30 percent with 98 percent test specificity. The urine test's cotinine-validated smoking prevalence was 54 percent, with a 26 percent self-denial rate. They also found that 15 (50 percent) of the patients who admitted smoking on the questionnaire underreported the amount they smoked daily.

"These findings have implications to health professionals who may only have a patient's self-reported smoking status preoperatively," the authors conclude. "There is a real need for smoking validation using biochemical tests not only to accurately assess the preoperative smoking status but also to help people reduce or abstain from smoking as part of a cessation program."

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