Here are the highlights from all the research on quitting for surgery. More data ➙

+ Smoking increases risks of surgery

Researchers found that smokers were 38% more likely to die in the 30-day period after surgery than non-smokers. Smokers were also significantly more likely to experience pneumonia, wound infection, heart attack, and septic shock.

Turan A, Mascha EJ, Roberman D, et al. Smoking and perioperative outcomes. Anesthesiology 2011; 114:837-46

+ Smoking weakens the healing process

Smoking restricts oxygenation of tissues and weakens the response of immune cells. This may lead to delayed healing and complications associated with wound healing after surgery. Quitting can restore proper blood flow in the short-term, but immune weakness may take four weeks to return to normal.

Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012 Jun;255(6):1069-79.

+ Quitting before surgery reduces complications

There are many benefits to reducing cigarette intake or abstaining altogether in the perioperative period, as this review found. These include reduced risk of lung complications (e.g. unanticipated ICU admission, respiratory failure), abnormal EKG findings, wound infection or dehiscence, and bone mending failure after bone procedures.

Warner DO. Perioperative abstinence from cigarettes: physiologic and clinical consequences. Anesthesiology. 2006 Feb;104(2):356-67.

+ Nicotine Replacement is safe for Surgery

Many surgeons believe that NRT is unsafe to use throughout the perioperative period; however, there is no evidence from human studies demonstrating that NRT increases the risk of healing-related or cardiovascular complications. The benefits of NRT (e.g. achieving and maintaining abstinence effectively) seem to outweigh the risks, especially if the patient were to continue smoking in the perioperative period.

Nolan MB, Warner DO. Safety and efficacy of nicotine replacement therapy in the perioperative period: A narrative review. Mayo Clin Proc. 2015 Nov;90(11):1553-61.

+ Smoking increases Health Care Costs after surgery

Health care costs during the first year after hospital discharge for an inpatient surgical procedure are much higher in former and current smokers. In this same period, current smokers are more likely than never-smokers to visit the emergency department at least once. Additionally, the number of hospitalizations is significantly higher among current smokers, and the length of hospitalization tends to be longer.

Warner, et al. Smoking Status and Health Care Costs in the Perioperative Period. JAMA Surg. 2014 Mar; 149(3): 259–266.

+ Having a surgery doubles quitting success rate

Smokers who underwent a major surgery had a successful quit rate that was 100% greater than the control group. Those undergoing a "minor" (outpatient) surgery were around 30% more successful. It is estimated that approximately 8% of all quit events in the United States annually can be attributed to surgical procedures. Shi Y, Warner DO. Surgery as a teachable moment for smoking cessation. Anesthesiology. 2010 Jan;112(1):102-7.