Perioperative Workup – Prospective Scoping Audit of Clinician Assessment of Perioperative Vaping Practices

Abstract

Aim: There is growing evidence to suggest that vape use may contribute to heightened perioperative risk [1]. Use has exponentially increased in recent years [2], however, in the absence of compelling data describing health impacts, there are no definitive perioperative guidelines on vaping. This audit aims to determine whether elective surgical patients are being counselled specifically on vape cessation in the perioperative period, and to compare and contrast this with smoking.

Methods: A prospective audit was conducted on 206 elective surgical patients at a tertiary hospital over a 4-week period between 04/03/24 – 31/03/24. A structured questionnaire was applied to all eligible participants to determine their smoking and vaping habits, whether they were counselled to cease pre-operatively and by whom they were counselled.

Results: In the month prior to surgery, 23% of patients had smoked, while 11% had vaped. 85% of patients who smoked received peri-operative smoking advice, while only 17% of patients who vaped received peri-operative vaping advice. Where vaping advice was provided, it was delivered by the patients GP or surgical team and not by the anaesthetist.

Conclusion: Clinicians were far less likely to provide advice to patients who vaped, on vaping cessation, than to those who smoked. There remains a deficiency of high-quality studies on perioperative outcomes in patients who vape, and without compelling evidence to guide advice for patients, clinicians may be hesitant to do so. Further investigation is required to determine barriers to intervening on vaping. Furthermore, consistent documentation of patients’ vaping practices is a necessary first step to begin to understand the impact of vaping on perioperative risk.

Impact: This scoping audit provides simple, clear prospective data to identify clinician practices in relation to vaping, and is hypothesis generating as to why rates of enquiry and intervention are low. It serves to identify an avenue for quality improvement and further research.