Why stopping smoking before surgery matters

If you are going to have surgery and you smoke, you have probably heard from several people that you must stop. This article gives the reasons from medical sources so you know what stopping changes.

What does smoking do around surgery?

MedlinePlus writes that stopping smoking and nicotine products, including e-cigarettes, before surgery can improve healing and the result of the operation. It gives three reasons:

• The wound heals more slowly. Smoking reduces the oxygen reaching the cells at the wound, so repair is slower and infection is more likely.
• Clots in the leg. People who smoke and have surgery develop clots in the leg more often than non-smokers, and these clots can travel to the lung and damage it. The NHS also lists surgery as a risk factor for deep vein clots.
• Strain on the heart and lungs. Even when the operation goes smoothly, smoking makes the body, heart and lungs work harder.

About a collapsed lung, MedlinePlus also notes that people who keep smoking are more likely to have it come back. The discharge instructions for lung surgery likewise say to get help to stop if you smoke and not to let anyone smoke in your home.

What interval is suggested?

MedlinePlus says most doctors advise stopping cigarettes and tobacco products at least 4 weeks before surgery. If the gap between stopping and surgery reaches at least 10 weeks, the risk of problems falls further. Using nicotine gum close to the time of surgery is not encouraged.

These are general recommendations. The right time for you depends on the type of surgery, how urgent it is and your own situation, and the decision belongs to the surgeon and the anaesthetist. If your operation is sooner than these intervals, tell the team today so they can plan with you. The sources we read give no figure for this case, and we do not give one either.

If stopping is hard

MedlinePlus has these suggestions:

• Ask family, friends and colleagues to support you.
• Ask your doctor about nicotine replacement and stop-smoking medicines. Ask the care team too, so they fit with the surgery and anaesthesia.
• Join a stop-smoking programme. The same source says hospitals, health centres, community centres and workplaces sometimes run one, and joining raises your chance of success.
• If you stopped before and started again, do not lose heart. Most people who succeed have tried several times and learned from earlier attempts.

What to tell the surgeon

• How much, and for how many years, you have smoked cigarettes or a water pipe, and when you last did.
• Whether you have stopped, and since when.
• Whether you use nicotine replacement or a medicine to stop.

Hiding smoking does not help; the surgeon and anaesthetist need to know in order to plan. See also Getting ready for surgery.