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Scheduled for surgery? 3 things to consider

The Bottom Line

  • Every year, more than two million surgeries are performed in Canada.
  • Various strategies exist to help increase the chances of a smooth and successful recovery following surgery.
  • Intensive treatments can increase the likelihood of quitting smoking and stopping alcohol consumption prior to surgery, as well as reducing complications after surgery.
  • Including caregivers in hospital discharge planning can decrease the risk of older adults being re-admitted to the hospital and the length of rehospitalizations. 

Over two million surgeries are performed in Canada each year (1). While surgery can be a stressful topic to discuss, it’s important to have conversations about what we can do to increase our chances of a smooth and successful surgery and recovery. Smoking, alcohol consumption, and hospital discharge are three areas to consider tackling prior to having surgery (2-5). Click on the links below to learn more. 


1. Quitting smoking

Smoking increases the risk of experiencing complications during and after surgery (6). It does this by disrupting the delivery of oxygen to different parts of the body, weakening the immune system, and damaging the lining of the lungs. These issues can make breathing more difficult, increase the risk of pneumonia, decrease the ability to fight off infections, and hinder the body’s ability to heal (7-9). Research shows that pre-surgery behavioural treatments, such as face-to-face, telephone, or computer-assisted counselling, can help people quit smoking before their surgery. Additionally, intensive programs lasting four weeks or more appear to decrease complications following surgery and increase people’s chances of remaining smoke free after their surgery (2;3).


2. Reducing or avoiding alcohol consumption

Drinking multiple alcoholic beverages per day increases the risk of experiencing complications—such as bleeding, infections, and heart problems—post surgery (4). Alcohol does this by reducing heart function, lengthening bleeding time, increasing stress response, and weakening the immune system (4;10;11). Research shows that intensive strategies, which include education, withdrawal treatment, and medication and last 4 to 8 weeks, may increase the amount of people who quit drinking prior to surgery, decrease alcohol consumption post-surgery in those who continue to drink, and reduce complications like wound, heart, and lung-related problems following surgery (4).


3. Including caregivers in discharge plans

For patients, caregivers, and healthcare providers, it’s important to consider a patient’s next steps following a hospital stay. Questions like where the patient will go (e.g., home or another facility) and what is needed to ensure a safe and successful transition are top of mind. Mismanaging the discharge process can lead to emotional distress for patients and their caregivers, as well as patients not getting the care they need (12-29). Research shows that including caregivers in hospital-discharge planning can reduce the risk of the older adults they care for being re-admitted to the hospital, decrease the length of rehospitalizations when they do occur, and lower the cost of care after discharge (5).    


All in all, patients, caregivers, and healthcare providers can work together to have discussions about key changes and decisions that can be made prior to surgery that will contribute to more positive outcomes during and after surgery. 


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References

  1. Canadian Institute for Health Information. More surgerugers being done, but wati times are still long. [Internet] 2024. [cited September 2025]. Available from:
  2. Thomsen T, Villebro N, Moller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2014; 3:CD002294.
  3. Fiddes RA, Nikki McCaffrey N. Preoperative smoking-cessation interventions to prevent postoperative complications: A quality assessment and overview of systematic review evidence. Anesth Analg. 2024. doi: 10.1213/ANE.0000000000007187.
  4. Engholm JW, Pedersen B, Møller AM, et al. Perioperative alcohol cessation intervention for postoperative complications. Cochrane Database Syst Rev. 2018; (11):CD008343. doi: 10.1002/14651858.CD008343.pub3. 
  5. Rodakowski J, Rocco PB, Ortiz M, et al. Caregiver integration during discharge planning for older adults to reduce resource use: A metaanalysis. J Am Geriatr Soc. 2017; 65(8):1748-1755. doi: 10.1111/jgs.14873.
  6. Bluman LG, Mosca L, Newman N et al. Preoperative smoking habits and postoperative pulmonary complications. Chest. 1998; 113:883-9. 
  7. Pearce AC, Jones RM. Smoking and anaesthesia: preoperative and perioperative morbidity. Anesthesiology. 1984; 61:576-84. 
  8. Lourenco RV, Klimek MF, Borowski CJ. Deposition and clearance of two micron particles in the trachiobronchial tree of normal subjects – smokers and non-smokers. JCI. 1971; 50:1411-20.  
  9. Sorensen LT. Wound healing and infection in surgery: The pathophysiological impact of smoking, smoking cessation and nicotine replacement therapy: A systematic review. Annals of Surgery. 2012; 255:1069-79. 
  10. Tønnesen H, Petersen KR, Højgaard L, et al. Postoperative morbidity among symptom-free alcohol misusers. Lancet. 1992; 340(8815):334-337. 
  11. Tønnesen H, Kehlet H. Preoperative alcoholism and postoperative morbidity. Br J Surg. 1999; 86(7):869–874. 
  12. Naylor M, Keating SA. Transitional care: Moving patients from one care setting to another. Am J Nurs. 2008; 108(9 Suppl):58-63. doi: 10.1097/01.NAJ.0000336420.34946.3a
  13. Avoidable Hospitalization Advisory Panel. Enhancing the continuum of care: Report of the Avoidable Hospitalization Advisory Panel. Toronto (ON): Queen’s Printer for Ontario; 2011. 
  14. Forster AJ, Murff HJ, Peterson JF, et al. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003; 138(3):161-167. doi: 10.7326/0003-4819-138-3-200302040-00007.
  15. Kiran T, Wells D, Okrainec K, et al. Patient and caregiver priorities in the transition from hospital to home: Results from province-wide group concept mapping. BMJ Qual Saf. 2020; 29(5):390-400. doi: 10.1136/bmjqs-2019-009993.
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  25. The Change Foundation. Spotlight on Ontario’s caregivers. Toronto (ON): The Foundation; 2018.
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