The Effects of Smoking After Bariatric Surgery

What Happens if I Smoke Before and After Bariatric Surgery?

Studies demonstrate smoking after bariatric surgery has low or no effects on weight loss outcomes. However, it causes serious problems for patients including increased risk of ulcers, pulmonary complications,  infections, strokes, and heart attack, and also reducing the pace of wound healing.

Not quitting in the preoperative period also weakens your lungs and will result in respiratory complications. If you have a history of smoking, quit at least one month before the surgery and make sure you’re ready not to smoke ever again.

Post-Operative Effects of Smoking after Bariatric Surgery

If you’re a smoker, I definitely recommend you to quit not just before the surgical procedure, but after it as well. By undergoing bariatric surgery, you take a big step towards a healthy lifestyle. But smoking increases the risk of diseases such as diabetes and heart disease, the ones that we’re trying to eliminate using bariatric surgery.

In addition, bariatric surgery patients who are also smokers need to know whether their smoking habit before the surgery affects their post-operative life or not. Let’s look into a study to find the answer. According to a study, Smoking in bariatric surgery: a systematic review, smoking is highly associated with long-term, post-operative complications, marginal ulceration, and bone fracture to name a few.

Moreover, smoking was identified as a risk factor for an increased mortality rate. It also affects the severity of other postoperative complications such as pulmonary and wound complications.

Now that you have the big picture, let’s dig into the most common postoperative complications due to smoking before and after weight loss surgery.

Smoking after bariatric surgery

1. Pulmonary Complications

The lungs of smokers are already damaged and it takes 1 to 12 months for them to function normally. After weight loss surgery, you might experience breathing difficulties and a compromised immune system.

If you restart smoking after surgery, even if not instantly after the operation, you will put your lungs at the risk of infections, pneumonia, or other respiratory complications.

2. Ulcers

Smoking adults are already at risk of ulcer formation. Bariatric surgery is one of the factors that increase the risk of ulcers in all individuals. So, the probability doubles in smoking patients.

Your body heals ulcers usually by pumping blood to the stomach. But if you’ve undergone gastric sleeve or gastric bypass surgery, your stomach is smaller than its original size which decreases your body’s ability to heal ulcers.

Smoking also causes ulcer medication treatment disfunction, so you cannot use medications either.

3. Blood Clots

The poor blood circulation resulting from weight loss surgery increases the risk of blood clots for gastric bypass patients. Less than 1% of patients experience the entrance of blood cots into the lungs and heart and eventually, pulmonary embolism.

The ability to pump blood is even less in smoking patients which increases this number for them. Blood clots in smoking bariatric patients causes blood pressure, strokes, and heart attack more than in nonsmoker patients.

4. Wound Healing and Infections

The blockage of veins causes decreased blood flow in smokers. As a result, the healing process after the bariatric procedures slows down which brings about a lot of concerns for wound infections in smoking patients.

This is a logical concern because if there is not enough oxygenated blood is pumped into the surgical wound, the healing does not go as usual and will cause infections in the sections where intestines were cut and stapled. This is obviously a matter of concern in gastric bypass and sleeve surgery patients.

Effects of Smoking on Weight Loss after Bariatric Surgery

One of the main concerns of bariatric patients is that if they keep smoking, will it affect their weight loss outcomes and cause weight regain?

There is no definite answer to this question as we know smoking has different effects on the weight loss of different individuals. Some smokers lose weight after quitting and some others gain weight. Again we can check research that has studied the effects of smoking on the weight loss of bariatric surgery populations.

One study that particularly observed the impact of smoking on weight loss outcomes after bariatric surgery demonstrates that smoking habits are “not associated with weight loss outcomes after bariatric surgery.”

However, the main concern about smoking is not its effect on response rates and weight loss outcomes, but on the mortality rate of weight loss surgery patients and how it increases the risk of surgical complications. Due to this reason, patients are seriously encouraged to quit smoking even before the surgery and never try it again.

Gastric Bypass and Smoking

As you know, in gastric bypass a new stomach pouch is formed in your body. Smoking causes the narrowing of the entrance of this pouch. The result will be severe pain, vomiting, and nausea.

Tobacco causes a decrease in the blood flow to your stomach pouch because it shrinks the blood vessels. The carbon monoxide produced when smoking affects your blood cells’ ability to carry oxygen. As a result, the slow healing after bariatric surgery becomes a long-term concern.

Can I Use a Nicotine Patch or Gum?

Nicotine leads to a reduced blood supply and increases the risk of all the complications that were described in this article. So, the answer NO. Avoid any product that contains nicotine.


The effect of smoking on your post-operation life depends on your medical records as well. But do not think that the complications mentioned above are just for a short time after surgery and you can restart smoking years or months after surgery. The same points are true about consuming alcohol after surgery.

I have seen patients that started smoking years after the surgery yet again experience some of these complications.

In very severe cases, I have seen the death of patients as a result of smoking. So, please, if you really care about your health and are ready to start your journey to have a healthier life, quit smoking long before you have your bariatric surgery and never ever start it again 🙂

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