Smoking Increases Surgical Costs

Quitting smoking may save significant amounts of money when it comes to elective surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Smoking before and after surgery brings with it a whole host of complications. Quitting smoking, even just one year before surgery can yield outcomes that compare to non-smokers.

A recent study analyzed data from nearly 15,000 patients to reveal that smoking is costly when it comes to elective surgery. Post-operative complications are high risk and high cost for smokers.

"Talk to your doctor about getting help to quit smoking."

Aparna S. Kamath, MD, MS, assistant professor of internal medicine at the University of Iowa Hospital, led a study to investigate the relationship between smoking and elective surgical costs.

Information from 14,853 general surgery patients at 123 different Veterans Affairs (VA) Medical Centers over the course of a year was used to determine smoking patterns and surgical cost outcomes. Thirty-four percent were smokers at the time or within the last 12 months of surgery, 39 percent had quit smoking and not had a cigarette in the last 12 months, and the remaining 27 percent of patients had never smoked.

Dr. Kamath’s team looked very closely at the financial costs of the operation itself, length of stay in the hospital and any readmission within 30 days of the original discharge.

Since there are other risk factors and co-existing health conditions for smokers - coronary artery disease, hypertension and chronic obstructive pulmonary disease—there is a higher chance of medical complications for smokers.

Dr. Kamath’s team discovered that health care costs for non-smokers vs. former-smokers were not statistically significant. This is encouraging information for people who want to quit smoking.

Costs for smokers were 4 percent higher, at an average increase of $900 per patient, than costs for non-smokers, and 6 percent higher for more complicated procedures. Most of this monetary increase is due to ‘post operative respiratory complications’.

Dr. Kamath states, “This research just strengthens our belief that we should encourage patients to quit smoking before their operations because of respiratory complications, in order to improve their surgical outcomes. In addition, it provides health care stakeholders and decision makers with data to make a business case for preoperative smoking cessation interventions.”

This study will be published in the Journal of the American College of Surgeons, June 2012. No financial information was given and no conflicts of interest were found.

Reviewed by: 
Review Date: 
May 30, 2012
Last Updated:
August 21, 2012