Smoking Cessation Before Surgery

Timing of Smoking Cessation

Smoking cessation of 4-8 weeks before surgery is necessary to significantly reduce respiratory and wound-healing complications, as recommended by the World Journal of Emergency Surgery and Clinical Nutrition 1, 2, 3, 4
The risk reduction associated with cessation begins accruing after several weeks of abstinence, according to Chest 5
Short-term smoking cessation (less than 4 weeks) has unclear benefits for reducing postoperative respiratory complications, as reported by the World Journal of Emergency Surgery 1, 6

Decreases risk of specific complications, including wound complications (delayed healing, infection), as noted by the World Journal of Emergency Surgery 1

Face-to-face or telephone counseling with written materials is an effective cessation strategy, as stated by Chest 5

For abdominal and pelvic surgeries, smoking cessation of at least 4 weeks is strongly recommended, according to the World Journal of Emergency Surgery and Clinical Nutrition 1, 2, 4
For liver surgery, smoking cessation should be counseled at least 4 weeks prior to hepatectomy, as advised by the World Journal of Emergency Surgery 3

The limitations of the evidence make it impossible to justify delaying urgent lung cancer surgery solely to pursue smoking cessation, as noted by Chest 5
Patients who continue to smoke have a two to threefold increase in postoperative morbidity, as reported by Clinical Nutrition 7

Identify all smokers at initial surgical consultation, as recommended by the World Journal of Emergency Surgery 2
For elective procedures, recommend complete cessation at least 4 weeks before surgery, as advised by the World Journal of Emergency Surgery 1, 2, 3
For urgent procedures (e.g., cancer surgery), encourage immediate cessation but do not delay necessary surgery, as stated by Chest 5
Provide cessation support throughout the perioperative period, as recommended by Chest 5