Can smoking before surgery kill you? What to know

Smoking cigarettes before surgery or while recovering from it can increase the risk of experiencing complications. Some complications can be life-threatening.

In some extreme cases, doctors may refuse to operate on people who smoke.

Experts recommend that people undergoing surgery, especially cases requiring general anesthesia, stop smoking before the procedure. Quitting lowers the risk of certain complications that affect lung or heart health.

This article discusses what happens if someone smokes before surgery, how smoking interacts with anesthesia, and when someone should stop smoking before surgery.

In a 2021 study, researchers analyzed data from more than 328,500 people who had surgery between 2012 and 2019 in Michigan. Researchers found that out 1 out of 4 people smoke at the time of their surgery.

Cigarette smoke contains more than 4,500 chemicals, most of which can harm human health. Smoking before surgery can increase someone’s risk of experiencing complications during and after surgery.

Some of these can be life-threatening.

Potential complications include:

Breathing problems and lung infections

Smoking can prevent the lungs and heart from working fully. This impairment can translate into breathing problems during or after surgery.

Tobacco smoke can also damage the lungs and increase the risk of:

  • pneumonia
  • lung collapse
  • need a ventilator after surgery, this is a machine that breathes for someone

Heart problems

Smoking is a major risk factor for developing and dying from heart disease.

The chemicals found in cigarette smoke, such as nicotine and carbon monoxide, can greatly increase someone’s risk of developing heart-related complications, such as heart attack and stroke, during or after surgery.

Bone, joint and muscle problems

According to the American Academy of Orthopedic Surgeons, smoking can damage the health of bones, joints and muscles, resulting in poorer outcomes from orthopedic surgery.

Broken bones do not heal as quickly in people who smoke. Nicotine affects the body’s production of cells involved in the production of bones.

People who quit smoking tend to have improved results after surgical treatments for musculoskeletal injuries and conditions.

Weakened immune system

Smoking weakens the strength of the immune system, which makes it much more difficult to heal after surgery and increases the risk of developing infections.

Scarring or implant problems

People who smoke are more likely to experience scarring and lose implants inserted during certain procedures, such as breast reconstruction.

According to the American Society of Anesthesiologists, smoking can increase the risk of anesthesia complications. Concretely, it can lead to:

  • increased risk of respiratory events, such as chest infection
  • longer stay in the recovery room after the procedure
  • need for more anesthesia, which increases the risk of any associated anesthetic complications

Quitting smoking before anesthesia appears to greatly reduce the risk of complications after surgery. A 2011 study found that each subsequent smoke-free week can improve health outcomes after anesthesia procedures of 19%.

The World Health Organization (WHO) reports that not smoking for at least 4 weeks is consistently associated with better outcomes after surgery.

The American Society of Anesthesiologists states that quitting smoking as soon as the day before surgery can reduce someone’s risk of complications.

Although it may be beneficial to stop immediately before surgery, it is better to stop 1 week or more before surgery. Stopping as soon as possible would be most beneficial. Many experts suggest stopping 4-8 weeks before surgery.

Some studies show that stopping smoking more than 8 weeks before surgery can reduce the number of lung complications from 48% to 20%.

Studies also shows that the longer someone abstains from smoking before surgery, the less likely they are to experience complications overall.

Some evidence suggests that stopping immediately before surgery may have disadvantages:

  • Increased mucus production and airway reactivity can interfere with breathing.
  • Nicotine withdrawal can increase the risk of sleep problems, irritability, restlessness and depression.
  • Quitting smoking can increase feelings of being unable to handle stress.

Smoking while recovering from surgery can increase your risk of heart attack or heart problems.

Smoking after surgery also reduces blood flow, which interferes with the body’s healing process. The slower wounds heal, the more likely they are to become infected.

Infected wounds can cause serious complications if the infection becomes severe or spreads throughout the body. These complications include systemic shock, coma, and death.

According to WHOsmoking even one cigarette reduces the body’s ability to transport nutrients necessary for healing.

However, quitting smoking at least 4-6 weeks before surgery and staying tobacco-free for 4 weeks after surgery can reduce the likelihood of wound complications by 50%.

A number of national organizations and services can help people quit smoking and provide support. Many of them offer free services, including:

  • Quitlines: Get free assistance by calling 800-QUIT-NOW (800-784-8669). It connects people with a confidential, trained counselor who can help people start their cessation journey. They may also provide medications, such as nicotine replacement therapy gums or patches.
  • American Lung Association: The American Lung Association offers several services and programs to encourage and support people who are quitting smoking.
  • American Cancer Society: People can find detailed information how to quit smoking The organization also operates a hotline at 800-227-2345.
  • Centers for Disease Control and Prevention (CDC): That CDC offers comprehensive public and professional resources to help people quit smoking.
  • American College of Surgeons: People can find detailed instructions to prepare for Quit Day, including how to deal with nicotine withdrawal and more.

The body begins to heal as soon as someone quits smoking.

Immediately after smoking cessation, the lungs and heart return to normal levels of function. Nicotine and carbon monoxide levels decrease, which can improve the post-surgical healing process.

According to the American College of Surgeons, the timeline after someone quits smoking is as follows:

  • 48-72 hours after cessation: Mucus secretions in the airways increase and the airways become more reactive, which can result in coughing. Blood oxygen levels rise and blood carbon monoxide levels fall. The amount of nicotine in the blood and tissues decreases, as does any increase in heart rate (tachycardia).
  • 2-4 weeks after cessation: Mucus secretion in the airways begins to decrease and the airways become less reactive. Small hairs that line the airways (cilia) are reactivated and begin to move mucus out of the airways.
  • 4-6 weeks after cessation: Metabolic and immune function begins to normalize.
  • 8 weeks after cessation: The risk of post-surgical complications and death decreases.
  • 12 weeks after termination: Cilia activity and small airway function return to normal.

Smoking before surgery increases the risk of experiencing lung, heart and immune system complications during and after surgery.

Smoking after surgery can also interfere with the body’s healing process, increasing the risk of serious infections, coma and death.

Most health authorities suggest that people stop smoking as soon as possible, or at least 4-8 weeks before surgery, and to abstain from tobacco for at least 4 weeks after surgery.

Many resources are available to help people quit smoking and support them during the process. If someone has trouble quitting, they can seek help from a doctor or other health professional.

Can smoking before surgery kill you? What to know

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