Smoking causes breathing problems after surgery

Cigarette smoke damages smoker’s lungs in many complicated ways. Even smokers with no symptoms do not have normal lungs. Amongst the effects of smoking on your lungs are:

  • Inflammation of the lungs
  • Decreased ability to fight infection
  • Increased secretions
  • Decreased ability to get rid of secretions
  • Increased muscle and fibre in lung
  • Lower FEV1 (less ability to breathe out rapidly)
  •  Increased airway reactivity

If these effects have not gone on for too long, and have not created permanent damage to the lungs, they can be partly reversed by stopping smoking.

Anesthesiologists notice that smokers behave differently during anesthesia. For example, they are more likely to show signs of airway irritation in response to exposure to anesthetic vapours. They are more likely to suffer from post- operative respiratory complications than non-smokers. This could be anything from requiring a dose of an inhaler to being on life support in an intensive care unit.

Does stopping smoking help? Yes, but it takes time. While sensitivity to airway irritation decreases after a few days, the shortest period of non-smoking likely to reduce the risk of breathing complications is two weeks.

In one study (by Dr. MA Warner) the risk of postoperative pulmonary complications was 11% in non-smokers, 17% in smokers who had stopped for 8 weeks or more, and about 50% in those who quit less than 8 weeks before surgery or who never stopped. Other researchers (Kotani et al) have shown that it can take up to six months of non-smoking for some lung cells to return to normal.

Some people have suggested that there may be an increased risk of breathing complications in people who only stop smoking a few days before surgery. There is no clear proof that this is true. If you have four weeks or more before your surgery, stopping now gives you the best chance of getting both the heart and the lung benefits of stopping. If you have less time, then it may be reasonable to make plans to stop smoking the day before your surgery.

Experts agree that the risks of smoking are so great that it is always best to Stop Smoking For Safer Surgery.