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1 Introduction Postoperative delirium, a neuropsychiatric syndrome characterized by sudden confusion, altered consciousness, and attention deficits, is a prevalent condition among hospitalized patients, with incidence rates ranging between 11% and 56% and escalating to 73% in Intensive Care Units (ICUs) ( Numerous precipitating events and predisposing factors have been implicated in delirium onset, including older age, cognitive impairment, functional and sensory deficits, infections, physiological irregularities, pre-existing health conditions, medications, surgical procedures, and excessive alcohol consumption ( While various factors associated with delirium incidence have been investigated, the role of smoking in the pathogenesis of delirium has received limited attention