The Price of Smoking Tobacco After Surgery

Current and former smokers had more healthcare costs in year after surgery compared to nonsmokers

(RxWiki News) A tobacco smoking habit can cost a lot of money. Even healthcare costs for surgeries unrelated to smoking can be significantly affected by the habit.

A recent study found that current and former smokers paid significantly more money in health care costs for a year after a major, inpatient surgery than nonsmokers.

The researchers found that current and former smokers were more likely to visit an emergency room after hospital discharge than nonsmokers.

"Discuss the cost of your smoking habit with a doctor."

The lead author of this study was David O. Warner, MD, from the Department of Anesthesiology at the Mayo Clinic in Rochester, Minnesota.

The study included 678 pairs of current smokers versus nonsmokers, 945 pairs of former smokers versus nonsmokers, and 665 pairs of current smokers versus former smokers.

Five thousand ninety-three of the participants were the nonsmokers. All participants were from Olmsted County. All participants had some type of surgery at one of the two Mayo Clinical hospitals in Rochester between April 1, 2008 and December 31, 2009.

The average age of the current smokers was 46 years old, the average of the former smokers was 61 years old, and the average age of the nonsmokers was 49 years old.

The participants were evaluated on their tobacco use status (either current, former, or nonsmoker), type of tobacco used, and the current amount of tobacco used.

The researchers used medical records to obtain dates of major inpatient surgery and hospital bills to determine individual healthcare costs.

In addition, the researchers asked the participants to report insurance time, demographics (age, race, sex), and type of operation. The participants were followed-up for one year after surgery.

The findings showed that the cost of the initial hospitalization did not differ significantly between any groups. The initial cost of hospitalization for current smokers versus nonsmokers was $19,542 versus $19,337. 

Compared to the former smokers, the current smokers paid an average of $19,248 compared to $19,353. The formers smokers paid an average of $19,880 for the initial hospitalization compared to $19,536 for the nonsmokers.

There were significant differences for the postdischarge follow-up monthly cost between current smokers and nonsmokers and former smokers and nonsmokers.

The researchers found that the current smokers paid an average of $1,434 per month compared to the nonsmokers who paid an average of $1,034 per month — resulting in a $400 difference per month.

The former smokers paid an average of $1,397 per month versus $1,123 for the nonsmokers — resulting in a $273 difference per month.

The findings showed that the postdischarge follow-up monthly cost for the current smokers versus the former smokers was not significant.

The current smokers were more likely to have visited the emergency room at least once in the year after being discharged, and have more overall emergency room visits after being discharged from the hospital compared to the nonsmokers, with an average of 1.3 visits versus .7 visits.

The researchers concluded that both former and current smokers have significantly higher health care costs during the first year after major surgery. They believe that this excess cost adds up to approximately $17 billion yearly in extra health care costs in the United States.

This study was published on January 1 in JAMA Surgery.

The Mayo Foundation provided funding.

Review Date: 
January 5, 2014