Guidelines on smoking in the peri-operative period

Guidelines on smoking in the peri-operative period


Smoking worsens surgical outcome.  This has been demonstrated in over 300 studies.

People who smoke are at increased risk of peri-operative respiratory, cardiac and wound related complications.  Quitting smoking reduces the risk of complications.

They have higher rates of infection, poor wound healing, heightened pain complaints and increased lung complications.

For gastric surgery, smoking increases the risk of an ulcer or leak. For laparoscopic sleeve gastrectomy, that risk remains for 6 weeks after surgery. For gastric bypass surgeries, that risk remains lifelong.

Many smokers try to quit on their own however in the absence of additional support, each quitting attempt will only have a success rate of 4-7 per cent. In the absence of any interventions to support quitting, longer term abstinence after surgery is low, although successful permanent quitting does occur.

Multi-session counselling delivered via telephone Quitlines increased smoking abstinence at 12 months by a significant 25-50 per cent.

Quitting smoking for as little as three weeks has shown to improve wound healing. Longer preoperative cessation periods also seem to correlate with reduced rates.  At roughly 4 weeks of cessation prior to surgery, complication rates more closely reflect individuals without a smoking history

Quitting smoking for six to eight weeks results in sputum volumes that are not increased compared to non-smokers and improved pulmonary function.

Longer quitting is best.

Nicotine produces cutaneous vasoconstriction, decreased blood flow, delayed wound healing and an increased risk of gastric leaks or ulceration. Therefore, nicotine patches need to be avoided after surgery.

Therefore, if you currently smoke, you will have to demonstrate that you have been without cigarettes or nicotine replacement therapy for four weeks prior to surgery. You will need to remain without cigarettes or nicotine replacement therapy for:

At least 6 weeks after a laparoscopic Sleeve Gastrectomy

Lifelong after Gastric Bypass Surgery