Dear terminator1983, The short answer is yes, smoking can very much inhibit the growth of the new grafts, **especially** in the 2 weeks following a hair transplant procedure using any method whatsoever. Hair restoration surgery is basically a large exercise in wound healing. Thousands of wounds are created and we’re trying to have them all heal perfectly and nourish the newly transplanted follicles. Smoking or nicotine use of any sort causes a constriction of the blood vessels responsible for feeding the new grafts. I have had 3 “failures” in my 15 year career of performing exclusively hair restoration surgery, and all three were heavy smokers who did not stop in the period around their surgery. One man even left the facility to go to the parking lot to have a cigarette during his procedure! His results were predictably poor. I advise my patients to discontinue all tobacco/nicotine use for 21 days prior to and following the procedure, for a total of 6 weeks of abstaining. I hope this information is helpful to you. Kind Regards, Ken Anderson, MD, FISHRS