Smoking has been found to negatively interfere with healing. Smokers who have a broken bone, or any of the conditions discussed on this site, should consider quitting smoking to increase their chances of healing. It is known that nicotine reduces the size of blood vessels by about 25%, which means less blood, oxygen and nutrients are getting to the part of your body which needs to heal. Smokers may experience longer healing times, in some cases up to two months. Longer healing time leads to more time out of work and longer rehabilitation to get back to normal activities.
In the case of chronic wounds or chronic conditions such as Charcot, hammertoes or pressure ulcers, smoking may delay healing and reduce patient satisfaction with the result.
Between 40 and 50 million Americans smoke cigarettes. Lung disease, heart disease, nicotine addiction and hardening of the arteries are the major risk factors of smoking.
Cigarette smoke contains over 4,000 different chemicals, including 60 known carcinogens.
Cigarettes decrease lung function, increase coughing and cause more infections. Cigarette smoking narrows blood vessels and reduces absorption of nutrients from food.
- 20 minutes after quitting: heart rate and blood pressure drop.
- 12 hours after quitting: carbon monoxide levels in the blood drop to normal.
- 2 weeks to 3 months after quitting: circulation improves and lung function increases.
- 1 to 9 months after quitting: coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
- 1 year after quitting: the excess risk of coronary heart disease is half that of a smoker.
- 5 to 15 years after quitting: stroke risk is reduced to that of a nonsmoker.
- 10 years after quitting: lung cancer death rate is about half that of a continuing smoker. Risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas is decreased.
- 15 years after quitting: risk of coronary heart disease is that of a nonsmoker.
Most people would probably be surprised to know that smoking can also affect healing, not just of bones, but anywhere in the body.
Wound healing requires a steady supply of oxygen and nutrients. For a smoker, there is less oxygen circulating in the body. Exercise level and overall nutrition may be diminished. As a result, normal healing mechanisms may be weakened.
Reduced oxygen delivery to healing bones may delay healing or cause a nonunion. Cigarette smoking causes degeneration of the spine. Therefore, chronic smokers with a spinal condition requiring surgery, such as spinal fusion, are at greater risk of nonunion.
Smoking also affects hormone production. In postmenopausal women, smoking may reduce estrogen production and lead to osteoporosis or brittle bones.