Does Bariatric Surgery Affect Smoking Behavior?

Does Bariatric Surgery Affect Smoking Behavior?

Bariatric surgery has gained popularity worldwide as a surgical solution for medically supervised weight loss, particularly for the severely obese. Smoking is a method used by some individuals to curb their appetite and promote weight loss, though certainly no doctor would recommend smoking as a treatment. Among some candidates for bariatric surgery who are obese and smoke, there is also an assumption that the surgery and subsequent weight loss could have a positive impact on aiding smoking cessation, particularly if smoking has been used by obese patients to curb their appetite. To this point, however, there has been no research conducted on whether bariatric procedures have any impact on smoking behavior after the surgery is performed.

According to the US Centers for Disease Control, the rate of obesity in the United States is between 26-32% — nearly 1 in 3 Americans. In order to combat the obesity epidemic, weight loss surgery can be very effective for reducing the health risks associated with obesity. The American Society for Metabolic and Bariatric Surgery notes that “Surgery results in significant weight loss and helps prevent, improve or resolve more than 40 obesity-related diseases or conditions including type 2 diabetes, heart disease, obstructive sleep apnea and certain cancers.”

A new study conducted by researchers in Italy, published in Tobacco Induced Diseases and titled Smoking Habit in Severe Obese after bariatric procedures is the first to examine whether bariatric surgery has any effect on either increasing or decreasing subsequent smoking.

The study, led by first author Mauro Maniscalco of the Section of Respiratory Medicine, Hospital S. Maria della Pietà in Naples, Italy, assessed smoking behavior in 78 severely obese people who had undergone bariatric surgery. The investigators studied three types of techniques that are used for obesity treatment, including: non surgical intra-gastric balloon compared to lap-band laparoscopic surgery or sleeve gastrectomy/gastric bypass. The study participants completed a written questionnaire about their smoking behavior at the beginning of the study as well as 3, 6 and 12 months after the surgeries.

In general, there were no differences in smoking behaviors between the three groups. Statistically significant differences in smoking were seen only at 3 months, when the rate of quitting of the intra-gastric balloon group was higher than the other two groups.

In their study report, the researchers concluded that “Bariatric procedures have no effects on smoking habit of moderate-to-heavy smoker severe obese patients. The use of other traditional smoking cessation methods in patients undergone to bariatric procedures should be implemented.”

The study indicates that in those obese people who do smoke, it should not be expected that undergoing bariatric surgery or a non-surgical technique such as intra-gastric balloon, will make them stop smoking. Smoking cessation and obesity should therefore likely be treated as separate conditions. This is an important distinction that researchers believe should be pointed out to bariatric surgery candidates who smoke before they undergo surgery.

Smoking cessation is in fact recommended by the American Society for Metabolic and Bariatric Surgery Guidelines both before and after bariatric surgery due to the increased risk for of poor wound healing and the negative impact on health.

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