Surgery And Smoking - OrthoInfo - AAOS

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Cigarette smoking is recognized as one of the major causes of preventable disease.

Most people know that smoking is linked to heart and lung diseases, as well as to several cancers. However, you may not be aware that smoking also has a serious negative effect on bones, muscles, tendons, and joints, and that smoking often leads to poorer outcomes from orthopaedic surgery.

Studies have shown that:

  • The nicotine in cigarettes and chewing tobacco can cause a decrease in blood flow to areas of bone and tendon that are healing after surgery.
  • Smoking has a negative effect on fracture and wound healing after surgery.
  • Fractures (broken bones) take longer to heal in smokers because of the harmful effects of nicotine on the production of bone-forming cells.

Smokers (including those who vape) also have a higher rate of complications after surgery than nonsmokers — in fact, smoking may be the single most important factor in complications after surgery.

The most common complications caused by smoking include:

  • Poor wound healing
  • Infection
  • Poor final outcomes of surgery

Researchers have noted that patients who quit smoking have improved outcomes for surgical treatments of musculoskeletal conditions and injuries. This means smoking is a modifiable risk factor (one you can change) that can be addressed before surgery to give you the best possible outcome.

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