Smoking does not disqualify you from implants, but it roughly doubles the reported failure rate — and the damage happens in two separate windows.
Smoking does not disqualify you from implants, but it roughly doubles the failure rate reported in long-term follow-up, and it does the damage in two separate windows. The first is healing: nicotine constricts the small vessels feeding the surgical site, so the tissue gets less blood exactly when it needs the most. The second is long-term, because smokers lose bone around the implant neck faster and develop peri-implantitis more often. The fixture does not care that you smoke; the bone around it does.
Beyond nicotine there is temperature and pressure. Smoke reaches the palate hot enough to irritate a fresh wound, and the suction of drawing on a cigarette can disturb the clot in an extraction socket the same way it causes dry socket after a wisdom tooth. That is why the ban in the first 72 hours is absolute here, and why we ask about vaping as well — the suction is identical even without combustion products.
We ask for no smoking one week before surgery and at least two weeks after, and we say plainly that cutting down is not the same as stopping. If you tell us you will not stop, we still treat you, but we record it, we usually add a healing check around day ten, and the warranty conversation is a different one. Hiding it helps nobody — a surgeon plans differently for a smoker, and knowing beforehand is worth far more than the confession afterwards.
Heavy smoking moves some decisions. In a full arch we may prefer six implants over four so load is shared if one site struggles, which adds roughly €600 to €900 to the €2,900 All-on-4 starting price. In a single site we may stage the work rather than load it immediately. None of that is a punishment; it is the same principle any surgeon applies when healing capacity is measurably reduced.
One week before and at least two weeks after is our minimum, and longer is better. The small vessels in the gum recover much of their normal response within a few weeks of stopping.
It removes combustion products but keeps the nicotine and the suction, and both of those matter here. We apply the same absolute 72-hour rule to vaping as to cigarettes.