The negative influence of cigarette smoke on passive smokers-deteriorated pulmonary function tests and increased urine cotinine levels

Abstract

We read with great interest the manuscript entitled “Effect of smoking on reversing neuromuscular block” by Ozturk et al. (1), as well as the discussion between Erhan et al. (2) and the authors (3). Ozturk et al. (1), in their original manuscript, indicated that the time to reach train-of-four is longer for smokers; however, their results could not be significant, and the authors proposed larger populations and different perspectives to show if sugammadex use was affected by smoking. Erhan et al. (2) commented on the article with the findings of their study as they found a significantly longer duration of recovery and higher rates of respiratory complications, especially in the postoperative period, in passive smokers than in individuals not exposed to smoking (1, 4). They concluded that considering the possibility of the negative influences of either active or passive smoking on anaesthetic procedures, the findings of the study (1) about recovery times from muscle relaxants could be regarded as clinically relevant, and smoking exposure may be associated with an increase in complication rates and prolonged or troublesome recovery, especially in children. Ozturk et al. (3) appreciated Erhan et al.’s (2) comments and added the importance of cessation of cigarette smoking on human health and healthcare costs of the country (2).