Quit Smoking before Bariatric Surgery
Pre Weight Loss Surgery
Why You Must Quit Smoking Before Bariatric Surgery

You will have to quit smoking before bariatric surgery to decrease the risk of post-surgical complications. Not only does smoking lead to serious health concerns, but tobacco use before and after weight loss surgery can increase overall surgical risk and prolong the healing process.

We all know that smoking can cause many medical problems—including coronary artery disease, blood clots, chronic obstructive pulmonary disease (COPD), and increased cancer risk. In fact, tobacco use is the leading cause of preventable death in American adults, followed by obesity.

According to the CDC, around 16 million people are living with a disease caused by smoking. And for every person who dies from smoking, 30 more are seriously affected by a smoking-related illness.

Aside from the health risks that regular tobacco use carries, there is a severe risk of surgical complications if you do not quit smoking before bariatric surgery. Studies have shown that the risk of serious surgical complications doubles for smokers compared to nonsmokers. Also, individuals who regularly use tobacco products are 1.5 times more likely to experience less serious surgical complications as well.

Risk of Smoking Before Bariatric Surgery

1. Pulmonary Complications

After any surgery, you may experience breathing issues, and a compromised immune system as your body heals the surgical wounds. If you are a smoker, you likely already have damaged lungs, making it difficult to get enough oxygen needed for healing. This can decrease your lungs' ability to fight off infections, leaving you vulnerable to developing pneumonia or other respiratory complications.

2. Marginal Ulcers

Ulcers are already common in smoking adults, but after bariatric surgery, the risk of developing an ulcer significantly increases. In a healthy adult, ulcers heal naturally by pumping blood to the stomach. After the surgery, however, the smaller stomach limits blood flow to the stomach, thus impacting the ability of ulcers to heal.

3. Blood Clots

Blood clots are a risk for any individual after bariatric surgery due to poor blood circulation and decreased physical activity. In less than 1% of patients, blood clots can enter the lungs or heart, causing a pulmonary embolism. Smokers have a decreased ability to pump blood through the body, significantly increasing the risk of blood clots after bariatric surgery compared to nonsmokers.

4. Wound Healing and Infections

Surgical wound infections are a serious concern for patients who smoke before bariatric surgery. In general, smokers have decreased blood flow due to vascular occlusion (blockage of veins). The healing process can be significantly impacted if there is not enough oxygenated blood pumped to the surgical wound since bariatric surgery involves cutting and stapling the intestines. This can result in infections as oxygen is the primary source of wound healing.

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Other Reasons to Quit Smoking Before Bariatric Surgery

In general, smokers after bariatric surgery have a 30% increased risk of complications. Similarly, long-term smoking can decrease the ability to lose weight and increase the risk of future complications, such as ulcers at the site of surgery.

You risk surgery postponement or cancellation if you smoke within four weeks prior to your procedure. Some surgeons will not risk performing the surgery due to the complications and difficult healing process brought upon by smoking.

Though it may be difficult to quit smoking before bariatric surgery, overall life expectancy increases by about 10 to 15 years for patients who go through weight loss surgery. Meanwhile smokers, on average, see a decrease in life expectancy of about ten years when compared to nonsmokers. Therefore, we encourage all of our bariatric patients to quit smoking as they make a commitment to leading a healthier life.

Tips to Quit Smoking before Bariatric Surgery

  1. Throw away any boxes of cigarettes and ashtrays lying around.
  2. Find oral substitutes that can satisfy the urge to have something in your mouth, such as gum, straws, carrot sticks, and toothpicks.
  3. Set a goal as to why you are quitting and establish a date for when you will start.
  4. Make sure you have support. The more people who know you are trying to quit smoking, the more accountable you will be.
  5. Be prepared to distract yourself or to avoid circumstances in which you are will be tempted to smoke.
  6. Try smoking cessation medications, but consult with a physician first to find out which one is best for you.
  7. Understand that tobacco addiction is challenging to overcome, and most people will relapse. However, relapsing is not an excuse to quit. Learn from your mistakes and start again.

If you are committed to losing weight to live a healthier life, we urge you to follow these tips to quit smoking before bariatric surgery to reap all the benefits that come with breaking this bad habit.

Francisco Jacome, MD
Dr. Francisco Jacome is a Bariatric and General Surgeon at Doctors Specialists-Bariatrics and Surgical. He is board certified by the American Board of Surgery and is an active member of the American College of Surgeons, American Society for Metabolic and Bariatric Surgery. Dr. Jacome has particular interests in advanced laparoscopy, robotic surgery, ​and bariatrics. He is the founder of Heal Club, which exists to offer those battling with being overweight, a one-stop-shop approach to weight loss that works.
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