Smoking cessation: Acute effects
Advanced, Clinical - Respiratory/Pulmonary, Physiology - Respiratory
Cigarette smoking causes mucus hypersecretion, impairment of mucociliary transport, and narrowing of small airways. Improvement in ciliary and small airway function, as well as decreased sputum production, occurs slowly over a period of weeks after smoking cessation. The optimal timing of smoking cessation before surgery to reduce postoperative pulmonary complications remains unclear. Most suggestions are somewhere between 4-8 weeks. Despite the clear advantages of long-term smoking cessation, there can be disadvantages to smoking cessation in the immediate preoperative period. These include an increase in sputum production, patient fear of the inability to handle stress, nicotine withdrawal, and symptoms including irritability, restlessness, sleep disturbances, and depression.