Video transcript

Let’s go over how smoking and vaping can affect your injury.

You may already know that smoking has negative impacts on the heart and lungs, and your risk of cancer. Some people also know that smoking is the main controllable cause of osteoporosis, which makes bones weaker and more likely to fracture. Unfortunately, most people are not aware of how smoking can interfere with your recovery and healing following traumatic injuries — especially broken bones, surgery or soft tissue damage.

Any area of the body that needs to heal is reliant on having a good supply of oxygen and nutrients to the area.

Nicotine products — including cigarettes and nicotine vapes — cause your blood vessels to constrict. This reduces the amount of blood that flows towards your injury. Alongside this, cigarettes reduce the amount of helpful oxygen that your blood is able to carry within the same volume. Both of these effects compound to starve the healing area of resources needed for efficient healing.

Patients who continue to smoke after their injury are likely to experience slower healing. This is particularly relevant when it comes to injuries that are already at high risk of delayed healing and failed union — such as scaphoid fractures and clavicle fractures.

In some cases, significant delays to healing can lead to a more permanent failure of the bone to unite. To avoid this risk, clinicians may advise that you remain immobilised and inactive for longer periods, which naturally has a negative impact on your muscle conditioning. Where fractures that enter non-union cause persisting pain, some patients may need to be considered for surgery.

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Alongside the healing of deep tissues and bones, smoking can also impact the ability of skin to heal. This becomes an important consideration when deciding the appropriateness of surgery to repair a fracture. The decision to undertake surgery is always a balance of risks and benefits. Unfortunately, the risk of complications after a surgery can be significantly increased when the bone is weaker and healing is less effective.

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Vaping is often seen as a safer alternative to smoking tobacco. While it does avoid some of the harmful chemicals in tobacco smoke, most of the effects described here are caused by nicotine. That means that vapes containing nicotine will carry similar problems with blood flow and oxygen delivery.

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If you're a regular smoker or nicotine vape user, it’s worth considering a pause during your healing and rehabilitation period. While it would naturally be healthier to stop smoking altogether, even a temporary pause for two to three months can improve your functional outcomes and reduce the risk of lasting damage. If you’re interested in cutting down or stopping, support is available from your GP or through local stop-smoking services.