Anxiety issues in patients on the eve of planned thoracic surgery depending on smoking status

Background. Elective surgery can be a source of psychological stress for patients, which may worsen nicotine addiction and increase anxiety levels. Smoking in the perioperative period can significantly increase the risk of respiratory complications.
Objective. The aim of this study was to investigate the relationship between nicotine dependency and anxiety levels in perioperative patients, as well as to assess the effects of various tobacco use modification strategies (complete cessation, nicotine replacement therapy, and transition to heating systems) on anxiety dynamics.
Materials and methods. A total of 96 participants were enrolled in the study. They were divided into two groups: those with nicotine dependence and a control group. Anxiety levels were assessed using hospital scales. Three weeks after implementing various smoking cessation methods, group comparisons and dynamic assessments of anxiety were conducted.
Results. A high prevalence of anxiety was found among patients with nicotine addiction (77%), which was significantly higher than in the control group (53%). Gender differences were revealed: 84% of men who smoked had an increased level of anxiety (compared to 61% of non-smokers), while women who smoked had a lower level (32%) than the control group. After 3 weeks of follow-up, the lowest level of anxiety was recorded in the group that used nicotine replacement therapy, followed by those that switched to tobacco heating systems. In patients who quit without aids, anxiety levels were higher, and among those who continued smoking, the level did not change.
Conclusion. The data obtained confirms a close relationship between nicotine addiction and anxiety in patients. For patients who are not ready for immediate complete withdrawal, switching to tobacco heating systems can be considered as a temporary and transitional measure as part of an integrated approach to harm reduction, but it should not be encouraged as a way to encourage tobacco use. Further research is needed to clarify the long-term effects of various strategies and to develop approaches to treating tobacco addiction.

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