Tobacco use continues to be the leading cause of preventable death in the United States and the world. According to the Centers for Disease Control and Prevention, the prevalence of tobacco use among bariatric surgery candidates is similar to, if not greater than, the general population. However, tobacco use is a well-documented surgical risk factor.
Substantial research has examined the impact of tobacco use on bariatric surgery in particular. For instance, while the mortality risk associated with bariatric surgery is generally low (less than 1%), death is twice as likely for active tobacco users.
A history of and/or active smoking has also been shown to increase the risk of developing postoperative complications among bariatric surgery patients. Patients who smoked within one year of having bariatric surgery, compared to their nonsmoking counterparts, were 1.5 times more likely to develop any surgery-related problem within one month of having surgery.
Smoking can potentially disrupt breathing capacity and lung function in patients. Research reveals an association between tobacco use and respiratory complications following bariatric surgery. Patients who smoked cigarettes within one year of having bariatric surgery were at increased risk for developing pneumonia.
Smoking, defined as smoking one or more cigarettes per day, was shown to increase the likelihood of developing marginal ulcers and wound rupture postoperatively. A history of or active tobacco use was also shown to predict not only the development but also recurrence of marginal ulcers up to 12 months after bariatric surgery. In addition, slower rates of wound healing and infection have been noted more generally among surgery candidates who use tobacco. With higher complication rates during and after surgery, the potential for prolonged hospitalization also increases. Preliminary research suggests patients who smoke within a month of surgery may also require higher dosing of opioid medication for postoperative pain management.
In the face of these and other potential risks, many bariatric surgery-related guidelines exist for addressing tobacco use. The latest evidence-based bariatric surgery guidelines recommend advising tobacco users to quit tobacco at least six weeks prior to bariatric surgery, as well as, provide tobacco users with the necessary support for maintaining long-term abstinence.
If you are considering bariatric surgery, contact VIPSurg for a consultation. If you are a smoker, he can get you the help and support you need to quit so that you can have surgery and become a healthier you!