In general smoking has numerous detrimental effects on health including significantly increasing the risk of heart attack, stroke, and lung cancer. Smoking is the most prevalent cause of preventable death in the United States based on data from 2004. Anyone who smokes and is contemplating anti-obesity surgery should plan to quit at the same time. The reduction in long term health risk will be maximized.*
With regard to gastric bypass surgery, smoking carries additional risk. It has been shown that tobacco intake reduces blood flow to small vessels throughout the body. This is especially important to healing at the bowel reconnection points. It is believed that smoking around the time of surgery increases the risk of leak from the bowel. This is a life threatening complication of gastric bypass surgery.
Also, it has been shown that smoking after gastric bypass increases the chance of forming ulcers at the connection point between the small pouch and the intestine. Ulcers can lead to bleeding, obstruction at the connection point and perforation, requiring emergency surgery. Intractable ulcers – those which will not heal on standard ulcer medication – occur at a much higher rate in smokers. Failure of an ulcer to heal may require re-operation to remove that part of the intestine.
All the available information suggests that patients who smoke should make every effort to give up tobacco prior to weight loss surgery.