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Why You Should Be Smoke-Free for Surgery

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Facing the Potential Risks | Zeroing in on Your Goal | Starting the Process

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

Like many people facing surgery, you may really want to quit. Or, you may think that smoking will not cause a problem for the particular type of surgery that you need. However, no matter what type of surgery you are having, smoking can increase your risk of complications. A large number of studies have found that, compared to nonsmokers, smokers may have an increased risk of:

  • Needing to stay in the hospital longer
  • Needing more follow-up visits with the doctor
  • Having more pain, bleeding, and less functioning after surgery
  • Getting an infection
  • Being sent to the intensive care unit (ICU)
  • Being readmitted to the hospital

One of the many concerns that doctors have about smoking is that it hinders wound healing. Nicotine triggers the blood vessels to become narrower, affecting blood flow. In addition, carbon monoxide, found in cigarette smoke, gets into the bloodstream, which means that there is less oxygen for the healing tissues. Just when your body needs more oxygen- and nutrient-rich blood, smoking acts as a barrier—blocking your body’s natural process to heal itself.

Zeroing in on Your Goal

Keep your goal in mind: to have a successful surgery with very few complications. No matter if you need surgery on your gums, shoulder, or any other body part, quitting smoking may help you heal faster and have a better outcome. Just think—having fewer complications can translate into less pain, a quicker return to your usual routine, fewer trips to the doctor and pharmacy, and more money in your pocket.

Even if your surgery is already scheduled, it is not too late to quit. While it is better to be smoke-free for months—rather than weeks—before surgery, making the decision to quit is an important one for your overall health. So if you are getting closer to the surgery date, use that as a reason to finally kick the habit.

If you think that quitting so soon before your surgery will not make a difference, the American Cancer Society points out that your heart rate and blood pressure are reduced just 20 minutes after quitting. And within 12 hours, the level of carbon monoxide in your blood is also reduced. Two weeks to three months of being smoke-free can result in better circulation and improved lung function.

Starting the Process

Do you feel inspired to quit, but do not know where to begin? There are so many smoking cessation options that you are sure to find one that fits your lifestyle. A great place to start the process is by making an appointment with your doctor. You will be able to get information about:

  • Nicotine replacement products, including patches, gum, and lozenges—While using one of these products is a much safer choice than smoking, you should still talk to your doctor about any potential risks nicotine may pose during or after surgery.
  • Nicotine inhalers or nasal sprays
  • Prescription medications that can reduce the symptoms of nicotine withdrawal
  • Smoking cessation classes and support groups
  • Alternative methods, such as hypnosis or acupuncture

In order to be successful with your quit plan, you may need to combine strategies, like using a nicotine replacement product and joining a support group. Try different methods to reach your goal of being a nonsmoker. Also, visit websites like the American Cancer Society and the American Lung Association, which provide a lot of smoking cessation resources. In addition, Smoke Free offers a “Step-by-Step Quit Guide.”

Are you waiting for your surgery to be scheduled? Now would be a good time to talk to your doctor about your desire to quit smoking. The surgery may be postponed (especially if it is elective) to give you more time to be smoke-free.


American Lung Association



Canadian Cancer Society



Lindstrom D, Sadr Azodi O, Wladis A, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg. 2008;248(5):739-745.

Lindstrom D, Sundberg-Petersson I, Adami J, Tønnesen H: Disappointment and drop-out rate after being allocated to control group in a smoking cessation trial. Contemp Clin Trials. 2010;31:22-26.

Nasell H, Adami J, Samnegard E, Tonnesen H, Ponzer S. Effect of smoking cessation intervention on results of acute fracture surgery: a randomized controlled trial. J Bone Joint Surg Am. 2010;92(6):1335-1342.

Smoking and wound healing. Univeristy of Wisconsin Hospitals and Clinics website. Available at: http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember-Show_Public_HFFY_1117547770797.html. Updated May 14, 2013. Accessed September 26, 2013.

Surgery and smoking. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00262. Updated July 2007. Accessed September 26, 2013.

Thomsen T, Tønnesen H, Moller AM. Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation. Br J Surg. 2009;96(5):451-461.

Thomsen T, Vellebro N, Moller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2010;(9):CD002294.

Tobacco use disorder. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated August 14, 2013. Accessed September 26, 2013.

Tonnesen H. Surgery and smoking at first and second hand: time to act. Anesthesiology. 2011;115(1):1-3.

When smokers quit—What are the benefits over time? The American Cancer Society website. Available at: http://www.cancer.org/Healthy/StayAwayfromTobacco/GuidetoQuittingSmoking/guide-to-quitting-smoking-benefits. Updated July 8, 2013. Accessed Septembe 26, 2013.

Last reviewed September 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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