Nicotine has deleterious effects on wound healing through increased vasoconstriction

Regarding your article supporting the use of e-cigarettes, 1 we wholeheartedly endorse any measure that reduces public health harm from smoking. The appropriateness of requiring patients to stop smoking before elective surgery has also recently been discussed. 2 3 There is considerable evidence that smoking is associated with poor wound healing, which is important in many types of surgical procedure, irrespective of specialty, 4 5 6 7 and smoking is contraindicated before some elective plastic surgery procedures. Although cigarette smoke contains a multitude of harmful components, nicotine is known to affect wound healing through increased vasoconstriction. 8 Recent data have...