Quit Smoking Now?
Smoking and Surgery

Creation Date: February 2004
Last Revision Date: February 2007
Peer Review Status: Internally Peer Reviewed

To many smokers, cigarettes calm them down. The thought of quitting smoking before an operation for cancer is just too much to ask. But, keep an open mind. Smoking can cause some serious complications for those undergoing general anesthesia and major surgeries. Some reasons to quit smoking before the operation:

• Prevent pneumonia–after a general anesthetic it is very important to cough and deep breathe. This clears the lungs and prevents pneumonia. Smokers have to cough much more often than non-smokers because they produce more sputum due to the lung irritation of the smoke. Smokers are much more prone to post-operative pneumonia, than non-smokers. By stopping cigarettes the chances of pneumonia are less. It may even cause you less pain!
• Wound healing–nicotine, found in tobacco, raises blood pressure by making the blood vessels smaller. This in turns causes problems with blood flow to a new surgical incision. An incision needs blood rich with oxygen to heal normally. A smoker's circulation is slowed down so an incision will not heal as well or as quickly as someone without nicotine in their blood.
• Prevent blood clots after surgery–nicotine thickens the blood. This can lead to blood clots forming and causing serious problems after surgery, such as a blood clot that travels to the lung.

Other long term advantages of stopping cigarettes:

• o Even if a person quits smoking when they are diagnosed with cancer, they will tend to have a better response to chemotherapy and radiation therapy, live longer and have fewer side effects from their treatments.
• o People with cancer who quit smoking reduce their risk of having their cancer come back and of getting another smoking related cancer.
• o The chances of getting emphysema, chronic bronchitis and coronary artery disease are lessened once smoking has ceased.

You may think the damage is done–that it is too late for you. But, that really is not the case. Within 20 minutes of smoking that last cigarette, the body begins a series of changes that continue for years. According to the American Cancer Society:

20 Minutes After Quitting:

• Blood pressure drops to a level close to that before the last cigarette.
• Temperature of hands and feet increases to normal.

Eight Hours After Quitting:

• Carbon monoxide level in blood drops to normal.

Two Weeks to Three Months After Quitting:

• Circulation improves.
• Lung function increases up to 30 percent.

One to Nine Months After Quitting:

• Coughing, sinus congestion, fatigue, shortness of breath decrease.
• Cilia regain normal function in lungs, increasing ability to handle mucus, clean the lungs, and reduce infection.

One Year After Quitting:

• Excess risk of coronary heart disease is half that of a smoker.

Five Years After Quitting:

• Stroke risk is reduced to that of a nonsmoker in 5-15 years after quitting.

Ten Years After Quitting:

• Lung cancer death rate about half that of a continuing smoker.
• Risk of cancer of the mouth, throat, esophagus, bladder, kidneys, and pancreas decrease.

15 Years after Quitting:

• Risk of coronary heart disease is that of a nonsmoker.

It is never too late. You can increase your chance of a healthy recovery from surgery by quitting smoking before surgery–the sooner, the better.

How to quit?

• "Cold Turkey"
• Nicotine Gum
• Nicotine Transdermal Patch
• Nicotine Nasal Spray
• Nicotine Lozenge
• Nicotine Inhaler
• Cigarette Filters
• Zyban
• Chantix

The Cancer Information Service has information on each of these quit methods. The CIS is located to the right of the Clinical Cancer Center Clinic registration desk.

If you feel you cannot quit, or that you are too nervous at this time to quit, talk to your doctor. He/she will be able to advise you on the best way for you to quit. The doctor might also prescribe something to temporarily calm your nerves during the time before surgery.