Hundreds of studies show that people who smoke have a harder time with healing. They take longer to recover from surgery. In the case of spinal fusion, smokers are more likely to have poor results. Compared to nonsmokers, smokers are almost three times more likely to experience nonunion of bone after a fracture or surgery.

Tobacco reduces the blood supply to a wound and increases a person's perception of pain. This means longer hospitalization, greater blood loss during surgery, and more pain medications after surgery.

Most physicians request a six-month break from smoking before surgery. Some will accept six weeks with a commitment to not smoke for up to six months during the recovery phase. The final outcome is well worth the effort.