The nicotine in tobacco products causes vasoconstriction (narrowing) of blood vessels throughout your body. Vasoconstriction decreases the blood flow to your wounds, thus decreasing the oxygen and nutrient delivery needed to heal those wounds. Hernias are due to weakening of the tissue in an area of the body with protrusion of the underlying contents. As a result, hernias are at risk for recurrence if they have impaired wound healing. I recommend patients be off of all tobacco products for at least 6 weeks before and after hernia repair to give them the best chance of healing, and preferably quite tobacco use permanently due to the potential long-term detrimental effects. Ziyad Hammoudeh, MD