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A comprehensive review article in the orthopedic literature instructs physicians to encourage all patients who are contemplating elective procedures to quit smoking four to six weeks in advance of the proposed procedure and should advise them of the serious negative outcomes associated with active smoking in the perioperative period. 2 Unfortunately, there is not one simple guideline or recommendation other than stop smoking entirely for as long as possible. When it comes to elective surgery, the longer a person can stop smoking before surgery the less likely they are to have complications, and its fair to use that 8-week time period since its been published in a high-profile journal ( JBJS )