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What should I do now – Smoking increases your risk for an operation by 1-2 times. Stopping (best at least 1 month ahead but earlier the better) reduces that risk

It is obvious that smoking has lots of different effects during and after surgery, from lung issues such as chest infections, poor wound healing from reduced tissue oxygen levels as well as a higher risk of the typical smoking risks such as heart disease and circulation problems.

Smokers often stay in hospital longer after an operation than non smokers.

Smokers are more likely to develop chest infections after surgery. Most people with serious chest infections make a good recovery. But getting a chest infection is one of the reasons smokers are more likely to die after surgery. You may need oxygen, antibiotics and sometimes life support on the Intensive Care Unit.

Broken bones heal more slowly or may fail to heal at all in smokers. Sometimes more surgery will be required.

Your wound will heal more slowly and is more likely to get infected if you smoke. Wound infections can also make you very ill, especially if caused by ‘super-bugs’ such as MRSA.

Smokers are more likely to have a heart attack or stroke during or after surgery, particularly if you have already had a heart attack or if you have angina, diabetes or high blood pressure.

Smoking affects your anaesthetic.  You are more likely to cough during anaesthesia and recovery. This makes some types of anaesthetic unsuitable for smokers.

Whilst some of these risks are due to the length of smoking that has built up damage over the years, some, such as chest infections and healing of wounds are likely to be improved in the short term by stopping smoking, by taking carbon monoxide out of the bloodstream.

Although one old study suggested lung cancer patients should continue to smoke before their operations, the general agreement is now that stopping even a short time before surgery and anaesthesia protects you from complications


Therefore even if you have tried to stop in the past, or stopped then restarted we strongly recommend you take this opportunity to stop again until your surgery.  Don’t avoid trying again just because you tried before.

See this leaflet from the Royal College of Anaesthetists

How to stop

Some people can stop simply by deciding to do so.

Many people need support for smoking cessation.  See below if we have local links

e-cigs.  We don’t know of any evidence about these with surgery but although the general evidence for their safety is still needed, because your carbon monoxide levels will be eliminated with e-cigs it seem likely these are safer than “traditional cigarettes” when it comes to surgery.

Whatever the case, take this opportunity to stop until after your operation (at least!)

What is the evidence

Smoking Evidence

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