Researchers find positive association between cosmetic surgery and smoking cessation

Undergoing cosmetic surgery may give some patients the little extra push they need to quit smoking, or at least smoke less, and therefore, preoperative consultations before such surgeries may be an opportunity for clinicians to promote long-term smoking cessation, according to results published in the journal Plastic and Reconstructive Surgery.

"Our results show an association between cosmetic surgery and smoking cessation at long-term follow-up," said lead author Aaron C. Van Slyke, MD, MSc, University of British Columbia, Vancouver, Canada. "Surgeons who request preoperative smoking cessation may influence patients' long-term smoking status."

For this 8-year, retrospective, cross-sectional cohort study, Dr. Van Slyke and fellow researchers included patients who smoked prior to their preoperative consultation for cosmetic surgery, who quit 2 weeks before surgery, and who subsequently underwent rhytidectomy, abdominoplasty, or mastopexy. At long-term follow-up, patients completed a Web-based survey.

Of the 85 smokers included, 47 completed the survey (response rate: 55.3%), and 5 were excluded because they were social smokers.

Of the 42 remaining daily smokers, a full 40.5% were no longer smoking on a daily basis. Of these, 23.8% reported that they had not smoked since their operation. Furthermore, 57.1% of patients had reduced their smoking by any amount.

In all, 70.8% of patients conceded that discussing the adverse surgical outcomes caused by smoking had influenced their ability to quit/reduce. Finally, 50.0% of patients admitted that they did not comply with the preoperative smoking cessation instructions.

Although the complication rate after cosmetic surgery was higher in patients who continued to smoke vs those who quit (24% vs 14%), this difference was not statistically significant. In two patients who did not follow preoperative instructions to stop smoking, more serious wound-healing complications occurred.

Taken together, these findings suggest that a more targeted message that specifically cites examples of the negative effects of smoking, rather than descriptions of general health benefits, may be more motivational to patients to quit.

"This is consistent with previous research showing patients who seek to obtain cosmetic surgery are more motivated to sustain positive lifestyle changes," wrote Dr. Van Slyke and coauthors. "[T]he dialogue between plastic surgeon and patient during the cosmetic surgery consultation serves as a unique moment to provide targeted smoking cessation counseling that may persist well beyond the surgical interaction," they concluded.