Quitting smoking before hip surgery
If you smoke, stopping before a hip replacement is one of the single most effective things you can do to lower your risk and recover well. The benefit is real, it is measurable, and support and medication make it far more achievable. Much of that help is free in Ontario.
Smoking changes how you heal
Nicotine tightens blood vessels and carbon monoxide lowers the oxygen your blood can carry. Together they reduce the blood supply that a healing wound and healing bone depend on. After a hip replacement, that shows up as more wound problems, more infections, and slower healing.
The research on joint replacement is consistent. Compared with non-smokers, people who smoke have higher rates of wound complications and deep infection around the new joint, and a higher chance of being readmitted or needing a further operation for infection in the first three months. A large review found smokers had roughly a 1.8 times higher risk of infection around the implant, the complication surgeons most want to avoid, because treating it can mean more surgery.
Why an implant infection is such a concern
A hip replacement is an artificial joint. If bacteria settle on it, antibiotics alone often cannot clear the infection, and fixing it can mean further surgery to wash out or exchange the implant. Lowering that risk before the operation is far easier than treating it afterward.
Stopping before surgery lowers the risk
This is a risk you can change, and quitting even in the weeks before surgery helps. In randomized trials, smokers who stopped before a hip or knee replacement, with counselling and nicotine replacement, had fewer wound complications than those who kept smoking. The evidence points to stopping at least four weeks before surgery to reduce wound infections, and longer is better.
The timing of your operation can flex to give you that window. Surgery for arthritis is planned, not an emergency, so there is usually time to get to a stronger starting point first.
- Improves the blood supply and oxygen your wound needs to heal
- Lowers the risk of wound problems and infection around the implant
- Lowers the chance of readmission and a return to the operating room
- Helps your lungs and heart handle the anaesthetic
- Benefits begin within weeks and keep growing the longer you stay stopped
- Every smoke-free week before surgery counts
- Cutting down helps, but stopping helps more
- Surgery is a natural reason to quit, and many people who stop for their operation stay stopped for good
- It is never too late, or too close to surgery, for it to be worth doing
You do not have to do it on willpower alone
Quitting is hard, and going it alone has a low success rate. What works is pairing support with medication, and it roughly doubles your chances.
- Counselling, a quit coach, or a helpline roughly doubles success and is free through the Ontario services below
- Set a quit date, tell the people around you, and remove lighters, ashtrays, and cigarettes from easy reach
- Expect it to take more than one try; each attempt teaches you what helps
- Nicotine replacement (a patch plus a fast-acting form such as gum or a lozenge) eases cravings; Ontario's STOP program provides it at no cost
- Prescription options such as varenicline or bupropion can further improve your chances
- Your family doctor or surgical team can help you choose what suits you and start it in good time before surgery
Bring it up early
The sooner you start, the more smoke-free weeks you bank before your operation. Mention it at your pre-surgical visit, or ask your family doctor now. There is no judgement here, only help getting you to your best starting point.
Where to start today
General guidance only, and not a substitute for advice from your own team. Links open in a new tab and point to trusted Canadian quit-smoking services. Your surgeon and family doctor will tailor a plan and any medication to you.