Ask Anesthesia

Quick Answer:

If you smoke or vape, you’ve probably been told to stop before surgery – but you may be wondering:

“Does it really matter if I smoke or vape before surgery?”

Yes – it matters more than most people realize.

Smoking and vaping can increase your risk of complications during and after anesthesia.

Why Smoking Before Surgery is a Problem

Smoking includes cigarettes, cigars, vapes, and marijuana and affects your body in several ways that make surgery riskier:

1. Less Oxygen in Your Blood

Tobacco and marijuana smoke contains carbon monoxide, which reduces how much oxygen your blood can carry.

During surgery, your body needs as much oxygen as possible to stay safe and heal properly.

2. Lung Irritation and Breathing Problems

Smoking irritates your airways and increases mucus production.

This can lead to:

• Coughing during or after surgery
• Difficulty breathing under anesthesia, including the inability of your anesthesia provider to breathe for you, which can result in death in severe cases
• Higher risk of pneumonia

3. Slower Healing

Nicotine narrows your blood vessels, which reduces blood flow.

This can cause:

• Slower wound healing
• Higher risk of infection
• Poor surgical outcomes

What About Vaping?

Many people think vaping is safer – but it still cause problems with anesthesia and surgery.

Vaping can:

• Irritate your lungs
• Increase airway reactivity (more coughing and airway spasms)
• Deliver nicotine, which reduces blood flow and healing

Vaping is NOT a safe alternative before surgery

What about marijuana?

Many people think that smoking marijuana is safer than cigarettes.

• THC in marijuana makes it more difficult to administer enough anesthesia, increasing your risk of awareness and complications
• Marijuana does not contain the filters that cigarettes have, potentially making it more harmful
• Marijuana smoke has all of the same risks to your lungs and ability to recover from surgery as tobacco smoke

When Should I Stop Smoking or Vaping?

Best case:

At least 4-8 weeks before surgery

This gives your lungs and body time to recover and significantly lowers your risk.

Even short-term quitting helps:

• 24-48 hours before surgery improves oxygen levels and decreases mucus and irritation
• 1-2 weeks greatly improves lung function

It’s never too late to stop – even quitting the day before is better than nothing.

Can I Smoke the Morning of Surgery?

No. You should NOT smoke or vape on the day of surgery.

Smoking right before surgery can:

• Increase airway irritation during anesthesia
• Raise your risk of complications
• Make it harder for your anesthesia provider to manage your breathing

What If I Can’t Quit?

Be honest with your anesthesia team. They are not there to judge you.

They can:

• Adjust your anesthesia plan
• Take extra precautions for your lungs
• Help reduce your risk during surgery
• Administer a breathing treatment before your procedure

Tips to Help You Stop Before Surgery

• Use nicotine patches or gum (ask your doctor first)
• Avoid triggers (coffee, stress)
• Stay busy leading up to surgery
• Remind yourself that this is temporary and for your safety

Bottom Line

Smoking and vaping both increase surgical risk.

The earlier you stop, the better your outcome.

Do NOT smoke or vape on the day of surgery.

Even a short break from smoking can make a real difference in your safety and recovery.