Smoking After Surgery and Wound Healing
Photo by Andres Siimon

Smoking After Surgery: How Much Does Smoking Slow Down the Healing Process?

Smoking and wound healing – is there a link?

Roughly 14% of adults in the United States smoke, and while many know the negative side effects of their habits, few know about issues with smoking and wound healing.

If you’re scheduled for surgery, you should stop smoking beforehand to speed up healing.

Unfortunately, many people think that their doctor is encouraging them to stop smoking before surgery because smoking is bad for them. While smoking may not be your healthiest habit, there have been concrete data dating back to the 1970s that smoking impacts wound healing.

Smoking and Wound Healing Statistics

Smoking harms your health, and since many people find smoking reduces their appetite, they also eat less. Wound healing demands a lot of energy from your body. If you’re not consuming enough nutrients, the healing process slows.

Smoking Before Surgery Risks

Smoking causes potential complications after surgery, including:

  • Higher risks of complications
  • Higher chances of anesthesia-related complications
  • The rise in heart-related complications

If your surgery relates to your heart or lungs, the risks of complications are even higher. WHO reports that smoking:

  • Reduces healing speed
  • Distorts immune system function
  • Delays healing

Additionally, smoking will continue to impact your body’s ability to heal after surgery, too. In fact, smoking has a negative effect on all four stages of the healing process:

  1. Hemostasis. Blood clot formation
  2. Inflammatory response. Defending against infection
  3. Proliferative. Fill the wound with new tissue and cover with skin
  4. Maturation. Time when the area gets stronger

Ironically, smoking helps improve clotting, but the clots are not formed optimally. Since the clot formation leads to the preparation of the wound site for healing, these suboptimal clots make healing harder for the body.

One study from Japan, which included more than 561,000 people, found that both 30-day postoperative complications and mortality were much higher for smokers.

How Long Before Surgery Should I Stop Smoking?

Smoking and wound healing are linked, but when should you stop smoking? Ideally, you’ll stop smoking six months before your surgery. However, the WHO states that your risk of complications during and after surgery fall in just four weeks.

For every additional week, your overall risk of complications falls 19% each week.


Blood flow. Smoking causes your blood flow to slow, and the nutrients that your wounds need to heal are not optimally delivered.

However, at the very least, you should stop smoking two weeks prior to surgery.

How Soon Can I Smoke After Surgery?    

Since you’ve already stopped smoking, it may be time to try and give it up for good. However, if you do plan to go back to smoking, it’s best to wait   2 – 4 weeks to pick up another cigarette. Different sources have different recommendations for when you can safely smoke again.

Since every surgical procedure is different, the risk of infection can be weeks or months.

Many procedures have an increased risk of infection for months. If you’re at a higher risk of infection, it may be best to stop smoking until the surgeon states that your infection risks no longer exist.

Vaping and Wound Healing

You’ve chosen to vape rather than smoke because it’s a “healthier” option. But is it? Due to the nicotine content in most e-cigarettes, the habit will also slow your healing down. In fact, nicotine is responsible for much of the healing issues with smoking because it’s shown to:

  • Narrow blood vessels, causing less oxygen to reach the wound. If less oxygen is present, it’s more difficult for the wound to heal and nutrients cannot reach the wound.
  • Blood clots will form, but the clots end up restricting the blood vessels and further impacting the healing process. In fact, the tissue needed for wound healing cannot receive the necessary oxygen and blood.
  • Nicotine also causes your blood pressure to rise, and if you’ve undergone a surgical procedure on your heart, the risk of heart attack also increases.

Stopping vaping prior to your surgery and for a month after the procedure is an effective way to help reduce the impact of wound healing. However, your rate of healing will often remain slower than your non-smoking counterparts that go in for surgery.

Smoking and wound healing should be considered before every surgery. If you have surgery planned, it may be in your best interest to stop smoking at least four weeks before surgery and plan to not smoke for at least for weeks afterward.

If you need help to stop smoking, be sure to consult with your doctor.