The evidence to support the negative effect of smoking on postoperative wound morbidity can be shown by a meta-analysis, including nearly 480,000 subjects in different surgical areas, which associated smoking with an increased rate of wound necrosis, dehiscence and SSI [7]. Specically in the context of abdominal wall repair, smoking has been routinely associated with wound morbidity. Because her­nia repair relies intensely on proper wound healing, any reduction of blood and tissue oxygenation and impairment in collagen deposition within fresh wounds can greatly affect the outcome of a hernia repair [2, 8, 9]. Additionally, abdominal wall repairs frequently require the use of mesh and various tissue plane dissections, and thus reinforce the need for smoking cessation before repair. An important study by Sorensen et al. demonstrated that smoking cessation for 30 days is adequate to show alleviation of many deleterious effects of cigarettes [10]. Given this high­quality literature demonstrating a clear correlation between active cigarette use and impaired wound healing, it should now be mandatory for patients to cease all smok­ing activity for a minimum of 30days preoperatively for those undergoing elec­tive hernia repair. Although laparoscopic and other minimally invasive techniques benet patients with reduced wound complications, active tobacco use still adds impairments to wound healing.