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Patients who smoke at risk of problems during surgery

Surgical risk for tobacco smokers

Study links this to nicotine and carbon monoxide

Patients who smoke tobacco are likely to experience more complications with anaesthesia during operation compared to non-smokers, says a report by World Health Organisation.

According to the international health agency, tobacco smokers are at a significantly higher risk than non-smokers of post-surgical complications, including impaired heart and lung functions, infections and delayed or impaired wound healing.

The joint study by WHO and University of Newcastle, shows that the nicotine and carbon monoxide, both present in cigarettes, can decrease oxygen levels and greatly increase the risk of heart-related complications after surgery.

“Smoking tobacco also damages the lungs, making it difficult for the proper amount of air to flow through, increasing the risk of post-surgical complications to the lungs,” says the study.

It further reveals that smoking distorts a patient’s immune system and can delay healing, increasing the risk of infection at the wound site.

“Smoking just one cigarette decreases the body’s ability to deliver necessary nutrients for healing after surgery,” explains Dr Shams Syed, Quality of Care coordinator at WHO.

However, the study emphasises that smokers who quit approximately four weeks or more before surgery have a lower risk of complication and better results six months afterwards.


The findings show that every tobacco-free week after four weeks improves health outcomes by 19 per cent, due to improved blood flow throughout the body to essential organs. “Complications after surgery present a large burden for both the healthcare provider and the patient. Primary care physicians, surgeons, nurses and families are important in supporting a patient to quit smoking at every stage of care, especially before an operation,” says Dr Syed.

“The report provides evidence that there are advantages to postponing minor or non-emergency surgery to give patients an opportunity to quit smoking, resulting in a better health outcome,” says Dr Vinayak Prasad, Head of Unit, No Tobacco at WHO.

WHO encourages countries to include programmes and educational campaigns in their health systems to spread awareness and help people to quit smoking.

Meanwhile, former smokers have four times more genetically healthy lung cells that have a much lower risk to progress into cancer than current smokers.

According to researchers, quitting smoking can do more than just stopping further damage to the lungs but also allow new, healthy cells to actively replenish the lining of our airways.

The study, published in the journal Nature, analysed lung biopsies from 16 people including smokers, former smokers; people who had never smoked and children.

Unexpectedly, in ex-smokers there was a sizeable group of cells lining the airways that had escaped the genetic damage from their past smoking. Genetically, they were found to be at par with those from people who had never smoked: they had much less genetic damage from smoking and have a low risk of cancer.