Smoking Behaviour and Beliefs About Smoking Cessation After Bariatric Surgery

Abstract

Purpose: Currently, bariatric surgery is the most effective intervention for treating morbid obesity and its complications. Smoking cessation is likely to improve smoking-related comorbidities and decrease postoperative complications. This study evaluated the smoking behaviour and thoughts about smoking cessation of patients more than 18 months after bariatric surgery.

Materials and methods: A cross-sectional study was performed in patients who underwent bariatric surgery from July 2012 to December 2013. A questionnaire was used to evaluate smoking status, thoughts about the health benefits of cessation and characteristics of previous quit attempts in current and former smokers. Finally, actual bariatric surgery outcomes were evaluated in current, former and never smokers.

Results: Six hundred nine patients (response rate 52.0%) were included. Of them, 101 (16.6%) patients were current smokers, 239 (39.2%) former smokers and 269 (44.2%) patients were lifetime never smokers. Compared with former smokers, current smokers were less aware of the beneficial effects of smoking cessation on their general health; 66.4% of the former smokers thought smoking cessation would be much better for general health, compared with 20.6% of current smokers. Total weight loss was 2.8% higher in current smokers compared with former smokers. Actual long-term bariatric surgery outcomes were not significantly different between the groups.

Conclusion: Despite advice to quit smoking and temporary quitting before surgery, a considerable group of bariatric surgery patients continues smoking after surgery. These patients were less aware of the beneficial effects of smoking cessation. This study emphasizes the need for better strategies to increase the number of successful cessations.

Keywords: Bariatric surgery; Beliefs; Comorbidities; Long-term outcomes; Smoking; Smoking cessation; Weight loss.

Fig. 1

Prevalence of smoking after bariatric surgery, combined with smoking behaviour category on day of surgery. At the time of questionnaire, 101 (16.6%) of the 609 patients reported to be a current smoker; on the day of surgery, 44 of them were current smokers, 23 were recent smokers, 31 preoperative former smokers resumed after surgery and 3 never smokers before surgery started after surgery. Two hundred thirty-nine (39.2%) patients were former smokers. The majority of them (n = 226 (94.6%)) was already a former smoker before surgery, 12 patients were recent/current smokers before surgery and one never smoker started and stopped after surgery. Two hundred sixty-nine (44.2%) patients were lifetime never smokers. The groups were significantly different after surgery (chi-square test p < 0.001)