Known Surgery Risks For Smokers

A large international study published in 2013 showed the dramatic differences in complications among smoking patients and those who were former smokers. This study showed that current smokers have a notably higher risk of dying in the 30 days following surgery. Most commonly, those deaths can be attributed to heart attack, stroke, inability to wean from the ventilator, respiratory failure requiring intubation and ventilator support, and pneumonia.

While the study compared smokers (defined as those had smoked in the year prior to surgery) with past smokers (history of smoking for more than a year in the past), the patient who quit smoking even a day prior to surgery has seen a lower risk in terms of surgical complications.

In addition to the severe complications known to accompany smoking, there are other complications that can hinder the patient’s ability to recover after surgery. Smokers are known to have a tendency for slower wound healing, greater scarring and higher rates of infection. Broken bones heal slower and coughing during the recovery phase is more likely, which can increase pain.

When to Quit Smoking Before Surgery

The sooner you can quit smoking prior to surgery, the better. With each passing smoke-free day, your overall risk of complications decreases. Quitting even 12 hours prior to surgery can make a difference, but quitting eight weeks before surgery can have a dramatic impact on your surgery and recovery.

When you quit matters:

• 12 hours before surgery: improved oxygenation, blood pressure, and heart rate
• 2 weeks before surgery: less breathing problems during surgery
• 3 weeks before surgery: wound healing improves
• 8 weeks before surgery: decreased risk of clot-related problems (heart attack and stroke) and risk of infection; improved immunity and response to anesthetic medications

Smoking After Surgery

Continuing to abstain after surgery will improve recovery time and continue to decrease the risk of complications. By refraining from smoking after surgery, wound healing is improved, the risk of pneumonia is decreased and overall recovery time is minimized.

The long-term benefits of being a non-smoker post surgery are enormous, including decreased risks of cancer, severe breathing problems and early death from other causes.

How to Quit Smoking

Giving up cigarettes is not easy, but it is worth the effort, especially before surgery. For some patients, quitting “cold turkey” without medication or nicotine replacement is the answer. For others, nicotine replacements are effective. Nicotine replacement means that you obtain nicotine from a source other than cigarettes, such as nicotine gum, patches, lozenges, and nasal sprays.

Medication is also an option. There are two medications commonly prescribed to help smokers quit the habit. The first is Wellbutrin, also known as Zyban or Bupropion, which is medication originally used as an anti-depressant but found to decrease the desire for cigarettes. The other medication is Chantix, a medication that mimics low doses of nicotine to help reduce withdrawal symptoms. Chantix also blocks the brain receptors that create a feeling of pleasure when smoking, making the experience of smoking a lackluster one.

Some patients report benefits from therapies that do not include medication or nicotine, while others have successfully used hypnosis or acupuncture to reduce the urge to smoke.