Dear May in Michigan,
Yes, even one cigarette is one too many. There are many effects due to smoking that can impact your surgery and results. Ignoring the pulmonary issues-which makes anesthesia more risky, the nicotine in the tobacco smoke significantly decreases the blood supply to the healing tissues and healing tissues need lots of blood supply to heal correctly.This is why a nicotine patch or gum is not a solution for surgery.
The carbon monoxide in tobacco smoke decreases the oxygen content that your red blood cells can carry so the blood that is getting there is less oxygen rich. Oxygen is needed to heal. There are other chemicals in smoke that also have impact but these are the two biggies.
Studies also show that less than one cigarette a day is necessary to cause all of the bad effects of smoking on healing. So, the recommendation is simple; stop smoking for at least 6 six weeks before your surgery. This is one of the things you can do to help you have a successful surgery.