Smoking and Hand Conditions


Smoking cigarettes, cigars, pipes and e-cigarettes have all been shown to negatively influence healing and worsen medical conditions in many parts of the body. This is due to nicotine, a chemical in these products. These effects can be seen in the hands and upper extremities.

Researchers have linked smoking with the following:

  • Reduced blood flow
  • Poor wound healing and/or complications
  • Poor bone healing
  • Increased circulation problems
  • Worsened nerve problems

All of the issues above can affect the hands and upper extremity. For example, reduced blood flow (the narrowing of blood vessels) can affect the very small blood vessels at the fingertips and the blood vessels that go to bone, nerve, and other important tissues in the hand and upper extremity.

Nicotine can also make some hand conditions worse.

  • Fractures (broken bones) have more trouble healing in smokers. Some fractures never heal.
  • Dupuytren's Contracture may be more common in smokers.
  • Nerve problems, due to too much pressure on the nerve, can be worse in smokers who also have other circulation problems such as diabetes. 
  • Reflex sympathetic dystrophy and cigarette smoking are statistically linked.
  • Skin wound healing is impaired with cigarette smoke and nicotine.

Smokers should stop smoking before surgery or when recovering from wounds from trauma, disease or recent emergency surgery.  It is best to stop smoking as soon as possible to allow your body to recover.

In some instances, your surgeon may ask you to take a nicotine test to prove that you have stopped smoking.  Speak to your physician about resources that can help you quit smoking.


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© 2017 American Society for Surgery of the Hand

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.



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