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Why You Should Be Smoke-Free for Surgery

IMAGE 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 (eg, periodontal, orthopedic, plastic surgery, etc), smoking can increase your risk of complications. More than 200 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
  • 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 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 (if you consider what you spend on copayments, prescriptions, and gas).
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. She can provide you with information about:
  • Nicotine replacement products (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 medicines (eg, varenicline, bupropion) that can reduce the symptoms of nicotine withdrawal
  • Smoking cessation classes and support groups
  • Alternative methods (eg, hypnosis, 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, Smokefree.gov 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.

RESOURCES

American Cancer Society http://www.cancer.org/

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

Smokefree.gov http://www.smokefree.gov/

CANADIAN RESOURCES

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

The Lung Association http://www.lung.ca/

References

Dotinga R. Quitting smoking simplifies surgical recovery. EBSCO Health Library, Health Day News website. Available at: http://www.ebscohost.com/healthLibrary/. Published November 12, 2009. Accessed June 26, 2011.

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.

Myers K, Hajek P, Hinds C, McRobbie H. Stopping smoking shortly before surgery and postoperative complications. Archives of Internal Medicine website. Available at: http://archinte.ama-assn.org/cgi/content/short/archinternmed.2011.97v1?rss=1. Published March 14, 2011. Accessed June 26, 2011.

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.

Preidt R. No complications from quitting smoking as surgery nears: study. EBSCO Health Library, Health Day News website. Available at: http://www.ebscohost.com/healthLibrary/. Published March 14, 2011. Accessed June 26, 2011.

Preidt R. Smokers more likely to bleed after throat surgery. EBSCO Health Library, Health Day News website. Available at: http://www.ebscohost.com/healthLibrary/. Published August 22, 2008. Accessed June 26, 2011.

Siegel J. Sizzling ways to stop smoking. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated March 15, 2011. Accessed June 26, 2011.

Smoking can harm the long-term effects of some oral surgery procedures. Perio.org website. Available at: http://www.perio.org/consumer/smoker-surgery.htm. Published September 18, 2007. Accessed June 26, 2011.

Smoking and wound healing. Trinitas Hospital Center for Wound Healing & Hyperbaric Medicine website. Available at: http://www.woundhealingcenter.org/SmokingandWoundHealing.pdf. Published July 2009. Accessed June 26, 2011.

Surgery and smoking. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00262. Updated July 2007. Accessed June 26, 2011.

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: other management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 6, 2011. Accessed June 26, 2011.

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 January 31, 2011. Accessed June 26, 2011.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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