Impact of Smoking on Postoperative Complications in General Surgery Patients
1Dr M. Azhar Qureshi, 2Dr Shakeel Ahmed,3Dr Muhammad Parvez,4Dr Aman Ullah ,5Dr Farhat Bano, 6Dr Kaleem Akhtar
Submission: 08 January 2026 | Acceptance: 10 February 2026 | Publication: 05 March 2026,
1Associate professor of General Surgery, Rawal Institute of Health Sciences Islamabad
2Assistant professor, Surgery department Karachi Medical and Dental college, Karachi
3HOD, Wah Medical College, Islamabad
4Petroleum Limited Sui Field Hospital, Sui Balochistan
5Associate professor surgery SMBBMC (Shaheed Mohtarma Benazir Bhutto Medical College)Lyari
6UHS
Abstract
Background
Due to its detrimental effects on wound healing, pulmonary function, cardiovascular health, and immunological response, cigarette smoking is a known risk factor for postoperative problems. Optimizing perioperative care and putting into practice successful smoking cessation initiatives require an understanding of how smoking affects surgical outcomes.
Objective
To assess the relationship between smoking status and complications following general surgery.
Methods
400 adult patients who had elective or emergency general surgery between January 2022 and December 2023 were included in a retrospective cohort research at [Name of Hospital/Institution]. Patients were categorized as either non-smokers, ex-smokers, or current smokers. Medical records were used to gather information on demographics, comorbidities, surgical procedures, and postoperative complications, such as surgical site infection, wound dehiscence, pulmonary problems, cardiovascular events, and systemic infections. Chi-square tests, t-tests, and multivariate logistic regression were used in the statistical analysis to ascertain if smoking and postoperative complications were independently associated. Statistical significance was defined as a p-value of less than 0.05.
Results
Of the 400 patients, 150 (37.5%) smoked now, 50 (12.5%) had smoked in the past, and 200 (50%) did not smoke. Surgical site infections (24% vs. 10%, p=0.001), wound dehiscence (12% vs. 4%, p=0.02), pulmonary complications (18.7% vs. 7%, p=0.005), ICU admissions (10% vs. 4%, p=0.03), and longer hospital stays (9.2 ± 3.5 vs. 6.8 ± 2.5 days, p<0.001). Current smoking was independently linked to a higher risk of surgical site infections (adjusted OR 2.1, 95% CI 1.3–3.4) and pulmonary complications (adjusted OR 2.5, 95% CI 1.4–4.5), according to multivariate analysis. Preoperative smoking cessation is beneficial, as evidenced by the decreased complication rates among former smokers compared to current smokers.
Conclusion
Patients undergoing general surgery are much more likely to experience postoperative problems if they already smoke. To lower morbidity, minimize hospital stays, and enhance surgical outcomes, preoperative identification of smokers and organized smoking cessation efforts are crucial.
Keywords
Smoking, Postoperative Complications, General Surgery, Surgical Site Infection, Pulmonary Complications, Wound Healing, Preoperative Smoking Cessation