African Journal of Anesthesia | 28 March 2018
Evaluating a Preoperative Smoking Cessation Programme to Mitigate Postoperative Pulmonary Complications in Elective Thoracic Surgery: A Qualitative Study from Rabat, Morocco
A, m, i, n, e, E, l, M, a, n, s, o, u, r, i, ,, K, a, r, i, m, A, l, a, m, i, ,, F, a, t, i, m, a, Z, a, h, r, a, B, e, n, j, e, l, l, o, u, n
Abstract
Smoking is a significant risk factor for postoperative pulmonary complications following thoracic surgery. Although preoperative cessation is advised, structured programmes are not routinely implemented in many low- and middle-income settings, such as Morocco. Their effectiveness and acceptability in these contexts are not well documented. This qualitative study evaluated a structured preoperative smoking cessation programme for patients undergoing elective thoracic surgery in Rabat, Morocco. It aimed to explore the experiences of patients and healthcare providers and to identify barriers and facilitators to implementation. A qualitative, descriptive study was conducted using semi-structured interviews. A purposive sample of 20 patients who participated in the programme and 10 healthcare providers (anaesthetists, surgeons, and nurses) was recruited. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. Three primary themes emerged: perceived reduction in postoperative symptoms, challenges to programme engagement, and the role of family support. A notable finding was that many patients reported subjectively less severe coughing and sputum production postoperatively than they had anticipated. Nicotine dependence and short notice before surgery were common barriers to complete cessation. Participants perceived the preoperative smoking cessation programme as beneficial for mitigating the severity of some postoperative pulmonary symptoms. The findings suggest potential value in integrating such interventions into thoracic surgery pathways in comparable settings. Programmes should be initiated earlier and include more intensive behavioural support for nicotine dependence. Involving patients’ families in the cessation process should be considered. Further research using clinical outcome measures is needed to substantiate these qualitative findings. Smoking cessation, preoperative care, postoperative pulmonary complications, thoracic surgery, qualitative research, Morocco This study provides insights into the perceived efficacy and implementation challenges of a preoperative smoking cessation programme within a Moroccan tertiary hospital, informing potential adaptations for similar clinical environments.