In facelift procedures, skin slough is an important complication and there is a strong association between smoking and higher skin slough rates [
2]. A similar relationship can be identified in abdominoplasty, as smokers suffer from a higher percentage of wound healing complications [
3]. Complications like T-junction necrosis and infections were also higher in smokers who underwent breast reduction [
4]. Regarding breast reconstruction, two studies showed higher rates of reconstructive failure and overall complications in smokers [
5]. However, no significant difference was found regarding flap loss and vascular thrombosis between smokers and non-smokers [
6]. In microsurgical free flap transfer, the relationship visited above is prevalent, with higher wound healing-related complication rates for smokers. [
7]. In hand surgery, it has been shown that smoking post-replantation decreases digital blood flow significantly [
8]. A meta-analysis showed the detrimental effect of smoking on the success rate of digit replantation (61.1% in smokers vs. 96.7% in non-smokers) [
9]. While there is no consensus regarding the optimal smoke-free period preoperatively, many authors agree that 4 weeks are capable of reducing the rates of smoking-related complications satisfactorily. Some authors support the use of cotinine measurement, as patient history can prove notoriously inaccurate [
10]. In order to improve the low cessation rate achieved by no intervention (about 1 in 8) [
11], nicotine replacement therapy and medication can be used effectively [
12].