Context

Prior studies show mixed results regarding the harms and benefits of smoking cessation prior to surgery. In one study, cigarette smoking demonstrated an increased risk of peri- and postoperative complications compared with not smoking.1 A recent systematic review found that smoking cessation interventions 4–8 weeks before surgery not only promote tobacco abstinence but reduce postoperative surgical complications.2 Whether to advise a smoker to stop smoking in the immediate preoperative period is controversial because sparse data suggest that smoking cessation might increase postoperative pulmonary complications due to a temporary increase in sputum production and a decreased cough reflex.3 This systematic review examines whether quitting smoking within 8 weeks before surgery is associated with postoperative complications.