We have not refused hyperbaric therapy to a patient who smokes. We encourage them to quit, offer different techniques and cessation programs if they are interested and inform them of the risks if they continue to smoke (focused on the diminished effectiveness of hyperbaric therapy and/or wound healing).
I agree with the poster who suggested a denial based on smoking is shaky ethical and legal ground. Similarly. we do not refuse advanced wound care treatments to patients who have uncontrollable diabetes with high glucose levels; instead we attempt to get their sugar under control while still treating their wounds and providing education. The same way we handle patients who smoke. While I understand that smoking diminishes the therapeutic effect of hyperbaric therapy - is there sufficient evidence to state they get absolutely no therapeutic effect?