Cigarette smoking has many adverse consequences, most of which are well known. What may not be so well known is that it affects skin quality by reducing the amount of blood, which circulates through the skin. This in turn also has an adverse effect upon wound healing. These effects may divided into two 'phases': an acute effect - ie when a cigarette is smoked one can measure a reduction in blood circulating through the skin, this is reversible since it only occurs when a cigarette is actually being smoked. Secondly, there is a chronic effect - ie if cigarette smoking continues over a long period of time then there are permanent changes in the blood vessels, which will not reverse.

If consideration is being given to any type of surgery, then it is wise to stop smoking if possible (at least two weeks before surgery). It is disadvantageous to stop smoking within a day or two of an operation since this is likely to create rather than improve a cough. If it is not possible to stop smoking, then certainly to reduce the number of cigarettes smoked is helpful.