Quit For Surgery

+ Smoking increases surgical risk

In a summary of 107 studies up to 2014, investigators found that the risk of wound problems like wound infections, lung problems like pneumonia, and the need of intensive care were almost doubled in smokers compared with non-smokers. Other studies since then have shown similar results.

Gronkjaer M, Eliasen M, Skov-Ettrup LS, et al. Preoperative smoking status and postoperative complications. Ann Surg 2014; 258:52-71

+ Smoking impairs wound healing

Smoking restricts oxygenation of tissues and weakens the response of immune cells. This may lead to delayed healing and complications associated with wound healing after surgery.

Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012 Jun;255(6):1069-79.

+ Quitting smoking reduces surgical risks

Many studies show that quitting smoking reduces surgical risks. This summary shows specifically that tobacco interventiosn (that is, efforts to help surgical patients quit) helps prevent complications.

Thomsen T, Villebro N, Moller AM. Interventions for preoperative smoking cessation. The Cochrane Database of Systematic Reviews 2014;3:CD002294

+ Nicotine Replacement is safe for Surgery

Nicotine replacement therapy, in the form of gum or patches, can double the chances of successful quitting. Although there have been some concerns about the vasoconstricting effects of nicotine, this review shows that the beneift of nicotine replacement outweigh any risks in surgical patients.

Nolan MB, Warner DO. Safety and efficacy of nicotine replacement therapy in the perioperative period: A narrative review. Mayo Clin Proc. 2015 Nov;90(11):1553-61.

+ Smoking increases Health Care Costs after surgery

Health care costs during the first year after hospital discharge for an inpatient surgical procedure are much higher in former and current smokers, in part because the number of hospitalizations is significantly higher among current smokers, and the length of hospitalization tends to be longer.

Warner, et al. Smoking Status and Health Care Costs in the Perioperative Period. JAMA Surg. 2014 Mar; 149(3): 259–266.

+ Having surgery doubles the chances of quitting

Major surgery more than doubles the chances of successfully quitting. Even those having a relatively minor outpatient procedure were about 30% more successful.

Shi Y, Warner DO. Surgery as a teachable moment for smoking cessation. Anesthesiology. 2010 Jan;112(1):102-7.

+ Treating surgical patients who smoke saves money

Smokers are at increased risk for complications such as wound infections that can significantly increase hospital costs. Providing tobacco treatment before surgery is a cost-effective means of reducing these costs.

.McCaffrey N, Higgins J, Greenhalgh E, White S, Graves N, Myles P, et al. A systematic review of economic evalutations of peroperative smoking cesation for preventing surgical complications. Int J Surg 2022,104:106742