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Healthcare costs higher for smokers after surgery

By Shereen Jegtvig

NEW YORK (Reuters Health) - Current and former smokers incur higher healthcare costs after having surgery than non-smokers, according to a new study.

"Smoking causes an estimated $17 billion in excess healthcare costs each year just because it is more expensive to take care of these folks in the first year after surgeries," Dr. David Warner told Reuters Health by email. He led the new study at the Mayo Clinic in Rochester, Minnesota.

Warner said helping surgery patients quit smoking benefits not only their post-operation outcomes but also their long-term health.

"Clinicians who care for surgical patients have the opportunity and responsibility to help their patients quit smoking," he said.

For their study, Warner and his colleagues used records from adults who had inpatient surgery at Mayo Clinic hospitals in 2008 and 2009.

The researchers matched 678 current smokers with an equal number of "never smokers" based on their age, gender, type of surgery and insurance. They also matched 945 pairs of former smokers and never smokers.

Costs of the original surgeries and hospital stays were similar for everyone, according to findings published in JAMA Surgery.

But compared to never smokers, healthcare costs for current smokers were higher during the year following surgery - by about $400 per month. Likewise, treating former smokers cost about $273 more per month than treating never smokers.

Warner's team found smokers required more frequent visits to the emergency room and more hospitalizations during that year.

"This is another example of how smoking has real costs to our society - costs that we all bear - and yet another reason that both public policy and clinical practice needs to focus on preventing and treating addiction to nicotine," Warner said.

Many of the former smokers in the study had only quit smoking after becoming seriously ill.

"Although quitting smoking dramatically improves health, not all of the damage can be reversed (for example, lung disease), and these tobacco-related diseases may still increase risks and costs," Warner said.

"The other thing to note is that when comparing current and former smokers, the former smokers were older, sicker, and needed more extensive operation - indeed, the older and sicker you are, the more likely you are to quit," he said.

The patients in this study were less diverse and more affluent than Americans as a whole, the researchers noted. So the effect of smoking on post-surgery costs could be different in other parts of the country where people have different access to healthcare.

"This study suggests that if we want to cut our healthcare costs, we should support smokers who want to quit by funding cessation services," Holly Jarman told Reuters Health in an email.

Jarman studies markets and health policy at the University of Michigan School of Public Health in Ann Arbor. She was not involved in the new study.

"In addition to the health benefits of not smoking, the study suggests that prevention is better than cure when it comes to healthcare costs," she said.

Jarman also said the study highlights the importance of preventing young people from taking up smoking in the first place.

"Adolescents are particularly sensitive to the addictive properties of nicotine. Yet, if people make it through those vulnerable years without starting to smoke, we know that they are much less likely to ever smoke," she said.

SOURCE: http://bit.ly/1ef5XOW JAMA Surgery, online January 1, 2014.

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