【abstract】objective To systematically assess the effects of smoking on opioids consumption for postoperative pain. Methods A literature search was performed in The Cochrane Library, Pubmed, Embase, CBM, CNKI and Wanfang database to collect the cohort studies on effects of smoking on postoperative opioids consumption. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, subsequently extracted the data, assessed the quality, data conversion and then conducted meta-analysis by RevMan 5.3 software. Results A total of 11 cohort studies involving 1029 nonsmokers and 619 smokers were finally included. Meta-analysis showed that the first 24h postoperative intravenous morphine equivalent(SMD (Standardized mean difference)=1.67，95%CI (Confidence interval) (0.99，2.35)，P<0.001), Weight-adjusted 24h intravenous morphine equivalent ((SMD=1.29，95%CI(0.21，2.37)，P=0.02) , the first 48 h postoperative intravenous morphine equivalent ((SMD=0.56，95%CI(0.29，0.83)，P<0.001) and Weight-adjusted 48h intravenous morphine equivalent (SMD=0.67，95%CI(0.43，0.91)，P＜0.001)in the smoking group is higher than nonsmoking group for PCA (Patient controlled analgesia), and there is no statistical difference in the incidence of postoperative nausea and vomiting and pruritus. Conclusion Smokers may be more sensitive to pain after surgery and more opioids analgesics requirement. In view of the limitations of the studies, Further research is necessary.