FAQ: Surgery and Smoking

Smoking and the musculoskeletal system:

Smoking can take a significant toll on the musculoskeletal system. Tobacco and nicotine increase the risk of bone fractures and interfere with the healing process, according to a growing body of research. Nicotine can slow fracture healing, estrogen effectiveness, and can counter the antioxidant properties of vitamins C and E. At a 2002 meeting of the American Academy of Orthopaedic Surgeons, research on the topic of smoking and its effect on the musculoskeletal system was reviewed. Some of the orthopedic problems caused by smoking include:

• more severe disc degeneration
•  weakened spinal ligaments
•  reduced production of bone cells
•  faster bone loss in postmenopausal women
•  fractures take longer to heal
•  rotator cuff surgery is less successful
•  longer healing time for surgical incisions
•  more post-surgery complications
•  delayed spinal fusion

However, quitting smoking seems to improve the healing process in most cases, except for long-term, heavy smokers who have permanent artery damage, according to the researchers. Those with permanent artery damage due to smoking may not heal easily when a peripheral part of the body is involved, since blood supply may be poor there.