Smoking causes lung disease and contributes to fracture nonunions, wound healing, higher rates of infection and many other side effects.

Risks

Increases a person’s risk for orthopaedic injuries and diseases, such as fractures and osteoporosis.

Reduces blood supply to bones, slows production of bone-forming cells, and decreases the body’s ability to absorb calcium from the diet

Increases a patient’s risk for pulmonary complications after receiving general anesthesia

Complications include:

• decreased pulmonary function
• poor tissue oxygenation
• infection
• wound healing
• cardiovascular events

Surgeon Tools/Recommendations

• Testing patients on the day of surgery for evidence of smoking with the nicotine blood test. (i.e. cotinine test).
  • Nicotine metabolized to cotinine in liver and may remain present for up to 10 days after nicotine usage.
• Utilize the Smoking Cessation Checklist that documents whether the patient is a current smoker or former smoker.
• Recommend patients to quit smoking at least 4-6 weeks prior to elective surgical procedures and least 6 weeks following the surgery.
• Provide patients with the Quit Smoking Before Your Operation, for patients to develop an action plan to quit.