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Note: The answers given here are for the purpose of providing general information regarding spine treatment. They are not intended to replace evaluation and treatment by your physician. If you have questions regarding your specific spine condition, we advise you to see a physician.

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Subject: Why is tobacco bad for a fusion surgery?

Question: I would like some information about the effects of tobacco (snuff in the lower lip) on a fusion surgery. My doctor wants me to quit chewing before my surgery and after. Do you konw why? Does this decrease the chances of the fusion working if I start chewing maybe a couple of months after the surgery?

Answer: Your doctor is giving you good advice.

There is very strong evidence that nicotine, in any form, markedly decreases the rate of spine fusion. The most important time is the first three months after surgery and the one or two months before surgery (you need to let the nicotine get out of your system).

In addition, nicotine increases the rate, frequency, and severity of disc degeneration. The data is firm in smokers, but not looked at in chewers. So, if your spine is bad enough to need surgery, you should quit permanently to increase the chances of long-term success.

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