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Why You Should Be Smoke-Free for Surgery

Your doctor has talked to you about surgery. Just the thought of it may cause you to feel stressed. If it is your habit to light up a cigarette during tense times, there are many reasons why you should kick the habit now—before your procedure.

Facing the Potential Risks

No matter what type of surgery you are having, smoking can increase your risk of complications. When compared to nonsmokers, smokers may have an increased risk of:

  • Respiratory and/or lung problems
  • Delays in wound and/or bone healing
  • Wound infection
  • A longer hospital stay
  • Longer recovery time
  • Need for care in the intensive care unit (ICU)
  • Problems that require return to the hospital

Delayed wound healing can affect all surgeries or injuries. Wounds need a steady supply of oxygen and other substances to heal well. Blood flow delivers these items. Smoking causes healing delays because:

  • Nicotine makes blood vessels tighten. This narrows the space for blood and slows flow to tissue. Healing tissue is very active. Regular good blood flow is needed for the healing process.
  • Smoking lowers the amount of oxygen in the blood. Blood flow is not only slowed, but there is less oxygen in the blood that does reach the area. It can take about 3 days of not smoking to bring blood oxygen levels back up to normal.
  • Smoking makes it hard for calcium from food to enter the body. Calcium is a mineral that the body needs to build bone.
  • Smoking lowers estrogen in women. Estrogen plays an important role in bone health.
  • Nicotine slows the production of bone-forming cells.

Zeroing in on Your Goal

Keep your goal in mind: to have a successful surgery with very few problems. Quitting smoking may help you heal faster no matter what type of surgery. This can mean less pain, a quicker return to your usual routine, fewer trips to the doctor, and more money in your pocket.

It is best to be smoke-free for months before surgery. However, if time did not allow, quit as soon as possible. Your heart rate and blood pressure can lower just 20 minutes after quitting. Within 12 hours, the level of carbon monoxide in your blood is also reduced. Two weeks to 3 months of being smoke-free can lead to better blood flow and improved lung function.

Starting the Process

There are many tools to help you quit. Talk to your doctor about your choices such as:

  • Nicotine replacement products—including patches, gum, and lozenges. These products still have nicotine which cause some problems. You and your doctor may be able to schedule the process to help you stop smoking step by step.
  • Nicotine inhalers or nasal sprays
  • Prescription medicine—can reduce the symptoms of nicotine withdrawal
  • Smoking cessation classes and support groups
  • Alternative methods, such as hypnosis or acupuncture

A combination of steps may help. Try different methods to reach your goal of being a nonsmoker. More support can be found on websites like:

Talk to your doctor about your risks before any surgery. Make sure they know that you smoke. The surgery may be postponed to give you more time to be smoke-free.

RESOURCES:

American Lung Association
http://www.lung.org

Smoke Free
http://www.smokefree.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

Osteoporosis causes and risk factors. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteoporosis-causes-and-risk-factors. Updated May 9, 2018. Accessed February 17, 2020.

Smoking and bone healing—a risky surgical combination. Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at: https://www.foothealthfacts.org/article/smoking-and-bone-healing-%E2%80%93-a-risky-surgical-combin. Accessed February 14, 2020.

Smoking and wound healing. UW Health website. Available at: https://www.uwhealth.org/healthfacts/tobacco/6150.pdf. Published January 2019. Accessed February 14, 2020.

Surgery and smoking. Ortho Info—American Academy or Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/treatment/surgery-and-smoking/. Published April 2019. Accessed February 14, 2020.

Last reviewed March 2020 by Michael Woods, MD, FAAP  Last Updated: 3/23/2020