Smoking and Vaping’s Impact On Your Body Before and After Surgery
Smoking/vaping is a leading cause of anesthetic and surgical complications. It also increases your risk of a prolonged stay in intensive care. Simply put, if you want a smooth surgery and a quick, stable recovery, you should stop using cigarettes and vapes before your procedure.
Read on if you’re curious about how smoking/vaping can impact your body during and following your operation.
Impact on Your Lungs
Anesthesiologists have noticed that smokers behave differently during anesthesia. For example, they are more likely to show signs of airway irritation when exposed to anesthetic vapours. Patients who are smokers are also 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.
None of this is surprising, considering that the damage cigarettes can do to lungs is well documented and includes:
Inflammation of the lungs
Increased airway reactivity
Increased secretions
Decreased ability to get rid of secretions
These problems can even be found in smokers with no symptoms of lung damage.
Thankfully, if these effects have not gone on for too long and have not triggered any permanent damage, they can be at least partly reversed by cessation, which is why we encourage you to quit today. Even stopping just two weeks ahead of your surgery will measurably reduce your risk of breathing complications!
While there has been some concern that ceasing smoking only a few days before surgery may increase the risk of breathing complications, there is no evidence that this is true.
Impact on Your Circulatory System
Cigarettes and vapes contain several nasty chemicals that stress your heart and can put it (and you!) at risk during surgery. For example, the nicotine found in cigarettes and vapes makes your heart beat faster and more forcefully, increasing the amount of oxygen it needs.
Cigarette smoke also contains carbon monoxide, which combines in your blood with a type of red blood cell called hemoglobin and creates something called carboxyhemoglobin. The result of this chemical reaction may be that your body, and notably your heart, does not receive all the oxygen it needs.
Together, these two conditions can potentially trigger a heart attack, where part of the heart muscle dies due to a lack of oxygen.
Impact on Infection and Surgical Healing
The chemicals in cigarettes and vapes, including carbon monoxide in cigarette smoke, reduce your blood’s ability to carry oxygen to your surgical incisions. This can increase the risk of infection and delay wound healing. Additionally, the cells involved in wound healing often have a type of receptor called nicotinic acetylcholine receptors, and these may not function normally in the presence of high levels of nicotine.
Smoking can also cause bone fractures to heal more slowly, and research has found that smokers who skipped the cigarettes following their spinal surgery recovered almost as well as non-smokers.
Need some extra motivation for cessation? Then consider the following:
Smokers have nine times the cardiac risk of non-smokers.
But even stopping smoking/vaping the night before your procedure can make a difference, especially for your heart; stopping just 12 hours before surgery dramatically causes levels of carboxyhemoglobin to drop, resulting in your heart getting more of the oxygen it needs.
Research has found that the risk of postoperative pulmonary complications was 11% in non-smokers, 17% in smokers who had stopped for eight weeks or more, and about 50% in those who quit less than eight weeks before surgery or who never stopped.
A 2025 review of 29 spine fusion surgeries found that smokers have poorer outcomes, including an increased risk of bones failing to heal properly.
In one study, stopping smoking for four weeks reduced the wound infection rate from 12% in smokers to 2% in non-smokers.