Why We Doctors Lecture Patients About Smoking

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I know from my experience in the clinic just how bored, and irritated, smokers are by the doctors who constantly tell them they need to stop smoking. I hate having to do it because I know that all smokers have tried on countless occasions to stop.

The reason I have to talk to smoking patients about this is that the risks of a surgical complication, ill health after surgery, an extended stay in hospitals or the need for high dependency treatment all increase significantly for smokers*. This is one of the reasons many NHS Trusts are now denying weight loss surgery to people who smoke.

As someone who spends much of my working day looking at the tissue of the stomach in my operating theatre, I can promise you that the quality of the tissue in a non-smoker is vastly superior to that of a smoker.

A study showed that smoking significantly increased the incidence of prolonged intubation (anaesthetic problems), reintubation, sepsis, shock, and length of stay.

This means that the risks of the stomach tearing or bleeding are increased. Its especially worrisome for patients that have sleeve surgery because the risk of staple line leakage, generally the hardest post-operative complication to treat, is increased.

I don’t expect my patients who smoke to give up permanently but it is important that they don’t smoke for a period before surgery. 4-6 weeks would be helpful and a similar period afterwards. Whilst we would prefer patients to stop smoking altogether we have to be realistic about what can be achieved.

So, if you smoke, please discuss it with your surgeon as it is likely to affect the type of surgery recommended and will certainly affect the pre-operative and post-operative regime.

This shouldn’t put smokers off weight loss surgery, they can achieve life-changing results, just like any other patient, we just need to make the appropriate arrangements for your safe treatment and recover.

Rishi Singhal

Rishi Singhal

Rishi is an expert bariatric surgeon based in the West Midlands and also Medical Director at Healthier Weight

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