Patient Resources
How to Stop Smoking
Before Surgery
Five Effective Ways to Stop Smoking Before Surgery
- Psychological Treatment: Hypnosis, behavioral therapy, and psychotherapy are commonly used to help people quit smoking. Success varies from person to person, depending on individual commitment. See APS & Find a Psychologist.
- Hypnosis to Stop Smoking: Clinical Hypnotherapy Sydney
- Counseling and Self-Help Programs: These programs can help smokers explore lifestyle changes and better understand the negative effects of smoking.
- Non-Nicotine Therapy: Medications that were initially developed as an antidepressant have shown promise in helping smokers quit. Consult your doctor for guidance.
- Nicotine Replacement Therapy (NRT): NRT helps reduce withdrawal symptoms like anxiety, irritability, and restlessness. Various options include nicotine gum, nasal sprays, and patches. Always discuss the appropriate NRT options and dosages with your healthcare provider to find the best approach for you. You will still need to be free of nicotine prior to surgery.
For additional support, contact the NSW Government’s QUITLINE.
If you have questions about how smoking or vaping might impact your surgery, or if you need assistance with quitting, please feel free to reach out to Dr. Mark Kohout’s office. Your health and the success of your surgery are our top priorities.
Why You Should Stop Smoking & Vaping Nicotine
- Smoking Affects Healing and Recovery: The negative effects of smoking on wound healing are well-documented. Numerous studies confirm that smokers face impaired wound healing, which is particularly concerning for patients undergoing cosmetic surgery.
- Smoking Affects Your Scars: Smoking can deplete your body’s Vitamin C levels, which is essential for collagen synthesis. Without enough Vitamin C, you may experience poor collagen production, resulting in more noticeable and disfiguring scars after surgery.
- Harmful Effects of Smoke and Smoking: Tobacco smoke contains harmful chemicals such as nicotine, hydrogen cyanide, lead, and arsenic, which can cause life-threatening complications and have a wide range of negative effects on the human body.
How Smoking, Nicotine & Vaping Affects Surgery
Smokers are at a significantly higher risk of experiencing complications during and after surgery. In fact, most people are not considered ideal candidates for cosmetic surgery unless they have quit smoking for a substantial amount of time before and after the procedure.
Research has shown that smokers are far more likely to experience complications after surgery. For example, one study found that smokers were 12.5 times more likely to suffer from skin necrosis after a facelift compared to non-smokers (Rees et al., 1984).
Smoking during the post-operative period impairs wound healing by reducing oxygen supply to tissues. Additionally, disrupted collagen production can lead to wider, more prominent scars or even complete wound breakdown.
- Increased risk of infections
- Fat cell necrosis (death of tissues)
- Loss of skin, nipple, or abdominal tissue after procedures like breast lifts, facelifts, breast reductions, or tummy tucks
- Life-threatening complications such as thrombosis or pulmonary embolism
- Increased post-surgical pain
- Implant rejection that may require additional surgery
Benefits of Stopping Smoking when having Surgery
A joint study conducted by the World Health Organization (WHO) and Newcastle University concluded that quitting smoking at least 4 weeks before surgery significantly reduces the risk of complications (WHO, 2020).
- 4-8 weeks of preoperative abstinence reduced surgical site infections by 57%
- Each week of cessation increased the magnitude of positive effects by 19%
- Cessation of at least 4 weeks showed larger benefits compared to shorter periods
FAQs about Surgery & Smoking
Why should I quit smoking before I have surgery?
By quitting smoking, you will not only reduce the likelihood of experiencing surgery-related complications, but also improve your overall health and even add years to your life. The benefits of quitting smoking include:
- Adding six to eight years to your life.
- Reducing your risk of lung cancer and heart disease.
- Saving a lot of money each year.
- Reducing your loved ones’ exposure to second-hand smoke.
What risks will I face during surgery if I do not quit smoking?
Smoking increases both anesthetic risks, as well as risks of complications during surgery and recovery.
Anaesthetic risks:
- More coughing
- Developing lung collapse
- Developing pneumonia
- More risk of post-operative and long-term pain
Surgical and Recovery Risks:
- Increased infection
- Increased risk of bleeding
- Poor healing
- Wound splitting apart
- Poor scars
Why is it important to the anaesthetist that I quit smoking before surgery?
Anaesthetists are the heart and lung specialists in the operating room, and they are responsible for the total-body health of patients. Therefore, they directly witness the immense toll smoking takes on a person’s body and must manage smoking-related complications.
Anaesthetists also witness the tremendous benefits patients experience as a result of not smoking before surgery, and are committed to helping all patients realize these advantages. It is important that your anaesthetist knows about your smoking so they can take precautions to reduce your risk of having problems.
How long before my surgery should I quit smoking?
The earlier you quit, the greater your chances of avoiding surgery-related complications. It is especially important not to smoke on the day of your surgery. Fortunately, the body begins to heal within hours of quitting. Twelve hours after a person quits, their heart and lungs already begin to function better as nicotine and carbon monoxide levels drop. It takes less than a day for blood flow to improve, which reduces the likelihood of post-operative complications. We recommend patients abstain from smoking at least 4 weeks before and after surgery, but even quitting for a brief period is still beneficial.
Is it worth quitting if I decide to do so right before surgery, such as the day before the procedure?
Quitting right before your operation may make you cough more, potentially increasing your risk of post-operative bleeding. Therefore, you are best quitting well before your surgery. If you decide to quit smoking the morning of surgery, it can still reduce the rate of some other surgical complications such as infection and poor wound healing.
If my surgery is minimally invasive, do I still need to quit smoking?
Smoking will impact your body before and after surgery regardless of the type of procedure you have. We recommend that all surgical patients abstain from smoking for as long as possible before and after surgery.
Before surgery, should I also quit smoking additional substances such as marijuana?
It is critical that patients quit smoking all substances before surgery, including marijuana. They can have the same detrimental effects on surgery as nicotine. For example, they can make patients more or less susceptible to anaesthetic. The carbon monoxide found in any kind of smoke affects blood pressure, making it more difficult for the blood to carry oxygen.
Please tell your anaesthetist or your surgeon if you have been smoking or using other substances before surgery. This information will remain confidential and is important to your care.
How long should I wait after surgery before smoking again?
Continuing to smoke after surgery greatly heightens a person’s risks of complications, such as infections in the surgical incision. In one study, more than half of patients who continued smoking after surgery developed complications, compared with less than 20 percent of those who quit. Fewer complications means less time in the hospital and a quicker recovery.
We recommend you do not smoke at all during the first 4 to 6 weeks after your procedure.
Should I take this opportunity to quit smoking altogether?
When confronted with surgery, many patients decide to change their behaviour for good. This defining moment is a great opportunity to commit to quitting, as it will have a significant impact on your quality of life for years to come.
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Dr. Mark Kohout
Dr. Mark Kohout is a highly qualified specialist plastic and reconstructive surgeon with over 25 years of experience, based in central Sydney.
Trained in Great Britain, Australia, and the U.S., he co-founded Australia Plastic Surgery. Specializing in breast, genital, and male breast surgeries, he is a certified member of the Australian Society of Plastic Surgeons (ASPS) and the Royal Australian College of Surgeons (RACS).
Dr. Kohout has appeared in media like The Biggest Loser and has published several articles in his field.
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