Search IconSearch
August 4, 2020/Health Conditions/Lung

3 Reasons Why Smoking Before Surgery Isn’t An Option

Smoking before surgery puts you at risk for death and other complications

man smoking cigarette

The list of benefits that go along with quitting smoking goes on and on, including reducing your risk of cancer, heart disease and early death. But what happens when you smoke but have an upcoming surgery and your doctor tells you to quit right away?


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Now is a better time than ever to stop smoking.

“Smoking before surgery puts you at a higher risk for postoperative heart attacks, blood clots, pneumonia and even death,” says pulmonologist Humberto Choi, MD. “When I schedule surgery, I tell my patients they should stop smoking right away.”

Even though it’s easier said than done, quitting smoking can make a huge difference in your health and recovery from surgery. In fact, the longer you abstain from smoking, the better your chances of a healthy recovery, among other benefits.

One JAMA study compared post-surgery risks for 125,000 people who smoke, 78,000 people who quit smoking at least a year before surgery and 400,000 people who have never smoked. In comparing people who smoke with people who quit smoking, researchers found that those who smoke were 17% more likely to die and 53% more likely to have serious heart and lung problems.

Yet people who'd quit smoking at least a year before surgery had no increased risk of death compared to those who'd never smoked.

“You should do your best to avoid cigarette smoke before surgery,” says Dr. Choi. “Secondhand smoke can cause coronary heart disease, stroke and lung cancer.”

Why smoking and surgery are a bad combo

Dr. Choi explains why smoking before surgery is risky:

1. It complicates anesthesia

The anesthesia team can tell immediately if the patient smokes.

“Anesthesiologists have to work harder to keep people who smoke breathing while under anesthesia, fighting against lungs compromised by cigarette smoke,” says Dr. Choi. “That makes it more likely that bronchodilator medications like albuterol must be used.”

The American Society of Anesthesiologists reports that smoking reduces blood flow and your surgical incisions are more likely to become infected since it slows healing.

2. The heart must work harder

Smoking compromises heart function, putting a patient at a greater risk for heart problems during or after surgery. That same JAMA study found that people who smoke had a 77% greater risk of heart attack after surgery than people who don't smoke.

Tobacco harms your heart and blood vessels. They disturb normal heart rhythms, contribute to inflammation and increase your blood pressure and heart rate. Not only that, but smoking increases your risk of heart failure, heart attack and dying from heart disease.


3. Wounds take longer to heal

Carbon monoxide in the body of people who smoke robs tissues of the oxygen they need to heal. The toxins in the blood of people who smoke also permeate the tissue, which further compromises the healing process. If you don’t quit smoking before surgery, you may be at higher risk for infections since oxygen is the main source for healing wounds.

Even if you quit 24 hours before your surgery, that can increase the amount of oxygen in your body. No matter if you’re new to smoking or you’ve smoked for 20 years, it’s still crucial to quit smoking on matter what.

The good news is that an upcoming surgery can be just the motivation a person who smokes needs to finally kick the habit. Quitting tobacco is always a good idea, and your upcoming surgery can be just what the doctor ordered. Talk to your doctor about resources that can help you quit smoking as soon as possible.

“Surgery is a great time to quit,” says Dr. Choi. “When I talk through the risks of pneumonia, heart attack and death, it helps patients understand the increased risks they face and highlights how they can improve their outcome.”


Learn more about our editorial process.

Related Articles

Hands of healthcare provider checking bangages on knee after surgery
June 21, 2024/Infectious Disease
Signs of an Infection After Surgery

Keep the area clean and monitor your incision site for discharge, odor or a change in appearance

Healthcare provider and patient talking in exam room
The Link Between Smoking and Bladder Cancer

Puffing on cigarettes is the leading cause of bladder cancer

close up of arm with nicotine patch on it
January 3, 2024/Lung
How (and Why) to Quit Dipping for Good

Nicotine replacement products and relaxation techniques can help you ditch the dip

various New Year's resolutions written in date planner, with weights and chocolate in foreground
December 28, 2023/Primary Care
8 Common New Year’s Resolutions and How To Keep Them

Whether you’re trying to work out more, drink less or manage stress, we can help set you up for success

mother breastfeeding baby
June 12, 2023/Children's Health
You’ve Had Breast Surgery — Will That Impact Your Ability To Breastfeed?

Severed milk ducts or lost glandular tissue may affect your milk production

Group exercise class at gym.
April 26, 2023/Heart Health
How To Improve Blood Circulation

Blood flow can benefit from leg elevation and even low-impact exercise, like walking

Closeup of a person smoking an e-cigarette.
October 31, 2022/Lung
Cigarettes, Cigars and Vaping — What’s Worse?

Each comes with substantial health risks and should be avoided

Young couple vaping at restaurant table outside.
October 25, 2022/Lung
How To Quit Vaping

Quitting vaping may not come easily, but it’s important to give yourself grace and patience

Trending Topics

Female and friend jogging outside
How To Increase Your Metabolism for Weight Loss

Focus on your body’s metabolic set point by eating healthy foods, making exercise a part of your routine and reducing stress

stovetop with stainless steel cookware and glassware
5 Ways Forever Chemicals (PFAS) May Affect Your Health

PFAS chemicals may make life easier — but they aren’t always so easy on the human body

jar of rice water and brush, with rice scattered around table
Could Rice Water Be the Secret To Healthier Hair?

While there’s little risk in trying this hair care treatment, there isn’t much science to back up the claims