Tobacco And Surgery

Quitting smoking before surgery and continuing to abstain after surgery is one of the most beneficial changes any surgery patient can make. The health benefits of quitting prior to surgery are immediate and substantial. Smokers having surgery can dramatically decrease their risk of complications during and after surgery.

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.


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More than 1 in 3 surgical patients has complications


About 38% of adult patients suffer an adverse event during or following their surgery, researchers reported Wednesday in the BMJ.

Nearly half of these complications result in serious, life-threatening or fatal harm, results showed.

60% of the complications were potentially preventable and 21% were definitely or probably preventable, researchers report.

"More than 1 in 3 surgical patients has complications

study finds, and many are the result of medical errors.
—CNN Health


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"About 38% of adult patients suffer an adverse event

About 38% of adult patients suffer an adverse event during or following their surgery, researchers reported in the BMJ.

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"2 in 100 people who have surgery develop a surgical site infection

The U.S. CDC estimates 1 to 3 in 100 people who have surgery develop a surgical site infection.


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"More than half of open-heart-surgery patients receive blood transfusions

But two new studies suggest that many of the transfusions provide little benefit.


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"Preoperative evaluation visit is associated with decreased risk of postoperative mortality

Anesthesiologists are well equipped to design and oversee the preoperative patient preparation process.

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Frequently Asked Questions

1. Who's behind Hoopcare?
Hoopcare is a telehealth service dedicated to preparing patients for surgery. Our team consists of world-class clinicians, including Richard Boyer, MD, PhD, who serves as our Chief Medical Officer and is affiliated with Weill Cornell Medicine. Our team has trained and supervised over 100 licensed clinicians to ensure you receive first-class preparation and optimization for your surgery. You can also find us on Zocdoc.
2. I need a physical examination, how does it work?
If you require a physical examination, Hoopcare will send you a telehealth pack. After scheduling your surgery, complete our online pre-surgery assessment to determine if you can receive your surgical clearance or if you need further preparation.
3. Can you tell me more about the Health Monitoring Surgery Box?
Certainly! Our innovative Health Monitoring Surgery Box is a comprehensive health management solution. It's designed to provide you with the tools needed to monitor your health accurately. This kit is not just a product but a commitment to your optimal evaluation and monitoring. Please note that all medical equipment is loaned, and we provide a free return shipping label.
4. Is Hoopcare legitimate? Will the letter will be accepted?
Absolutely! Hoopcare is a trusted telehealth service with a primary focus on pre-surgery checkups and clearances. Our Chief Medical Officer, Richard Boyer, MD, PhD, is affiliated with Weill Cornell Medicine. Additionally, we have received over 123 Google reviews with an average rating of 4.8, showcasing our commitment to excellence and patient satisfaction.
5. Are there any limitations for outpatient surgery?
While the website doesn't specify all the limitations, it's common for outpatient surgeries to have certain restrictions, such as high BMI or the complexity of the surgery. It's always best to consult with our expert clinicians to determine if you're a suitable candidate for outpatient surgery.
6. My surgeon requested an EKG, how do I proceed?
If your surgeon has requested an EKG or any other tests, Hoopcare can assist. We provide at-home EKG services, among other tests, to ensure you're fully prepared for your surgery.
7. I need to send documents, how do I do that?
You can send your documents to docsend@hoopcare.com or upload them directly in the Hoopcare application for a seamless experience.
8. Are the costs of labs and other paraclinical examinations included?
No, the costs for labs and other ancillary services, such as medical equipment, are not included in our pricing. However, these costs are usually covered by most healthcare plans.
9. How do you determine if I can have a fast track clearance in less than 48 hours?
Fast track clearance in less than 48 hours is determined based on your health assessment and risk factors. If you don't require a physical examination and are deemed a low-risk patient, you might be eligible for this expedited service.