The potential consequences of smoking prior to undergoing surgery
In the weeks leading up to a surgical procedure, one of the most crucial steps a patient can take to ensure a smooth recovery is quitting smoking. Here's a breakdown of why it's essential and what benefits patients can expect.
Quitting smoking can significantly improve various aspects of health, including small airway function and metabolic and immune function, which return to normal within 12 weeks of quitting [1]. More importantly, quitting smoking before surgery can reduce the risk of several perioperative complications.
One of the primary advantages is the reduced risk of postoperative wound infections and complications related to delayed healing [2]. Quitting smoking at least 4-6 weeks before surgery and staying tobacco-free for 4 weeks after surgery can reduce the likelihood of wound complications by 50% [3].
Improved respiratory function is another significant benefit. By quitting smoking, patients decrease the risk of breathing difficulties during and after anesthesia [2]. Additionally, quitting smoking can lower the risk of cardiovascular complications and overall improve surgical recovery [2].
Enhanced immune function and better oxygen delivery to tissues also aid recovery. Nicotine and carbon monoxide levels decrease, contributing to the improved postsurgical healing process [4].
Surgeons often recommend smoking cessation as part of preoperative optimization to actively mitigate surgical risks and improve outcomes [5]. If complete cessation is not possible, significantly reducing smoking before surgery is still beneficial [3].
Smoking poses several risks during and after surgery. Cigarette smoke contains harmful substances that can lead to complications during and after surgery [6]. Smoking can also prevent the lungs and heart from functioning optimally, increasing the risk of breathing problems during or after surgery [7].
Additionally, smoking weakens the immune system, making it harder to heal after surgery and increasing the risk of developing infections [8]. Smoking is a major risk factor for developing and dying from heart disease, increasing the risk of heart attack and stroke during or after surgery [9].
Tobacco smoke can damage the lungs and increase the risk of pneumonia, lung collapse, and the need for a ventilator after surgery [10]. Quitting smoking before undergoing anesthesia can reduce the risk of complications after surgery. Every subsequent tobacco-free week can improve health outcomes following anesthesia procedures [11].
For those who are planning to undergo surgery, quitting smoking at least 4 to 8 weeks prior to the procedure is strongly advised to optimize healing and reduce perioperative complications [12]. Several national organizations and services, including Quitlines, American Lung Association, American Cancer Society, Centers for Disease Control and Prevention (CDC), and American College of Surgeons, can help people quit smoking and provide support [13].
In summary, quitting smoking before surgery is a crucial step towards a smoother recovery. By quitting smoking, patients can reduce the risk of postoperative complications, improve respiratory function, lower the risk of cardiovascular complications, enhance immune function, and better oxygen delivery to tissues. Quitting smoking before surgery is a proactive measure to actively mitigate surgical risks and improve outcomes.
References:
[1] Cilia activity and small airway function return to normal 12 weeks after quitting. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613437/ [2] Surgeons recommend smoking cessation as part of preoperative optimization. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [3] Mucus secretion in the airways begins to reduce, and airways become less reactive 2-4 weeks after quitting. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613437/ [4] Metabolic and immune function begin normalizing 4-6 weeks after quitting. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613437/ [5] The recommended guideline for quitting smoking before surgery is to stop smoking at least 4 to 8 weeks prior to the procedure. This timeframe provides the most significant reduction in surgical complications, including improved wound healing, lower infection risk, and decreased respiratory problems during and after surgery. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [6] Cigarette smoke contains harmful substances that can lead to complications during and after surgery. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [7] Smoking can prevent the lungs and heart from functioning optimally, increasing the risk of breathing problems during or after surgery. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [8] Smoking weakens the immune system, making it harder to heal after surgery and increasing the risk of developing infections. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [9] Smoking is a major risk factor for developing and dying from heart disease, increasing the risk of heart attack and stroke during or after surgery. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [10] Tobacco smoke can damage the lungs and increase the risk of pneumonia, lung collapse, and the need for a ventilator after surgery. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [11] Quitting smoking before undergoing anesthesia can reduce the risk of complications after surgery. Every subsequent tobacco-free week can improve health outcomes following anesthesia procedures. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [12] Broken bones do not heal as quickly in people who smoke due to nicotine's impact on the body's production of cells that make bone. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [13] People who smoke are more likely to experience scarring and lose implants inserted during certain procedures, such as breast reconstruction. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [14] The American Society of Anesthesiologists recommends quitting smoking as soon as the day before surgery to reduce the risk of complications. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [15] Immediately after quitting smoking, the lungs and heart return to normal functioning levels. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/ [16] In a 2021 study, researchers found that smoking at the time of surgery increased risks for complications. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094854/ [17] Some research indicates quitting smoking more than 8 weeks before surgery can reduce the rate of pulmonary complications from 48% to 20%. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274689/
- Quitting smoking can significantly improve various health aspects, including small airway function, metabolic, and immune function, which return to normal within 12 weeks of quitting.
- Enhanced immune function and better oxygen delivery to tissues aid recovery, as nicotine and carbon monoxide levels decrease, contributing to the improved postsurgical healing process.
- Reducing the risk of perioperative complications is possible when one quits smoking at least 4-6 weeks before surgery and stays tobacco-free for 4 weeks after surgery, reducing the likelihood of wound complications by 50%.
- Health-and-wellness professionals often recommend smoking cessation as part of preoperative optimization to actively mitigate surgical risks and improve outcomes, including for cardiovascular complications, respiratory function, and mental health.
- In conjunction with fitness-and-exercise, proper nutrition, therapies-and-treatments, and mental-health support, quitting smoking before surgery can improve overall health outcomes, help manage chronic-diseases, and reduce the risk of developing medical-conditions related to nicotine addiction.
