Skip to Content
800-533-8762
  • Careers
  • Newsroom
  • Health Care Professionals
  • About Us
  • Contact Us
UPMC
  • Find a Doctor
  • Services
    • Frequently Searched Services
    • Frequently Searched Services
      Allergy & Immunology Behavioral & Mental Health Cancer Ear, Nose & Throat Endocrinology Gastroenterology Heart & Vascular Imaging Neurosciences Orthopaedics
      Physical Rehabilitation Plastic & Reconstructive Surgery Primary Care Senior Services Sports Medicine Telemedicine Transplant Surgery Walk-In Care Weight Management Women’s Health
      See all Services
    • Services by Region
    • Find a UPMC health care facility close to you quickly by browsing by region.
      UPMC in Western Pa. Western Pa. and New York
      UPMC in Central Pa. Central Pa.
      UPMC in North Central Pa. North Central Pa.
      UPMC in Western Md. Maryland & West Virginia
    • See All Services
  • Locations
    • Locations by Type
    • Locations by Type
      UPMC hospitals
      Hospitals
      Physical Therapy
      Physical Therapy
      Urgent care
      Walk-In Care
      UPMC Outpatient Centers
      Outpatient Centers
      UPMC Imaging Services
      Imaging
      Community Health Centers
      Community Health Centers
      See All Locations
    • Locations by Region
    • Locations by Region
      UPMC in Southwest Pa. Southwest Pa.
      UPMC in North Central Pa. North Central Pa.
      UPMC in Northwest Pa and Ny. Northwest Pa. & Western N.Y.
      UPMC in West Central Pa. West Central Pa.
      UPMC in Central Pa. Central Pa.
      UPMC in Western Md. Maryland & West Virginia
    • See All Locations
  • Patients & Visitors
    • Patient & Visitor Resources
    • Patient & Visitor Resources
      Patients and Visitors Resources Pay a Bill Classes & Events Medical Records Health Library Patient Information
      Patient Portals Privacy Information Shared Decision Making Traveling Patients Visitor Information
      Man uses mobile phone
      Pay a Bill
      Nurse reviews medical chart
      Request Medical Records
  • Patient Portals
  • Find Covid-19 updates
  • Schedule an appointment
  • Request medical records
  • Pay a bill
  • Learn about financial assistance
  • Find classes & events
  • Send a patient an eCard
  • Make a donation
  • Volunteer
  • Read HealthBeat blog
  • Explore UPMC Careers
Skip to Content
UPMC
  • Patient Portals
  • For Patients & Visitors
    • Find a Doctor
    • Locations
    • Patient & Visitor Resources
    • Pay a Bill
    • Services
    • More
      • Medical Records
      • Financial Assistance
      • Classes & Events
      • HealthBeat Blog
      • Health Library
  • About UPMC
    • Why UPMC
    • Facts & Stats
    • Supply Chain Management
    • Community Commitment
    • More
      • Financials
      • Support UPMC
      • UPMC Apps
      • UPMC Enterprises
      • UPMC International
  • For Health Care Professionals
    • Physician Information
    • Resources
    • Education & Training
    • Departments
    • Credentialing
  • Careers
  • Contact Us
  • Newsroom
  • UPMC >
  • Media Relations >
  • News Releases >
  • 022120 King RYGB Smoking
Media Relations
News Releases
Central Pa. News
North Central Pa. News
Contact Us
Experts
Community-Focused News
Media Kits
Media RSS
Media Relations
News Releases
Central Pa. News
North Central Pa. News
Contact Us
Experts
Community-Focused News
Media Kits
Media RSS

Smoking Relapse Common in Weight-Loss Surgery Patients

For Journalists

Allison Hydzik
Director, Science and Research
412-647-9975
hydzikam@upmc.edu

Erin Hare, Ph.D.
Manager, Science Writing
412-738-1097
HareE@upmc.edu

Want to Make an Appointment or Need Patient Information?
Contact UPMC at

1-800-533-8762.

Go to Find a Doctor to search for a UPMC doctor.

2021 PITT HS horiz

2/21/2020

PITTSBURGH – Although 1 in 7 adults smoke cigarettes the year prior to undergoing weight-loss surgery, nearly all successfully quit at least a month before their operation. However, smoking prevalence steadily climbs to pre-surgery levels within seven years, according to new research led by the University of Pittsburgh Graduate School of Public Health.  

 

The findings — reported today in the Annals of Surgery — suggest that there may be missed opportunities to engage patients in interventions to improve long-term smoking cessation rates, particularly at regular post-surgery checkups. 

 

“Smoking cessation prior to surgery is strongly recommended to reduce surgical complications,” said lead author Wendy King, Ph.D., associate professor of epidemiology at Pitt Public Health. “But there isn’t the same emphasis on maintaining cessation after surgery. Our findings show that there is a need for ongoing support in order to reduce and quickly respond to relapses.”

 

King and her colleagues followed 1,770 adults who underwent Roux-en-Y gastric bypass surgery — a procedure that reduces the size of the stomach and bypasses part of the small intestine — for seven years post-surgery, annually surveying them about their smoking habits. The participants were enrolled in the National Institutes of Health-funded Longitudinal Assessment of Bariatric Surgery-2 (LABS-2), a prospective, observational study of patients undergoing weight-loss surgery at one of 10 hospitals across the United States.

 

Smoking And Bariatric Surgery Graph releaseMore than 45% of the participants reported a history of smoking prior to surgery, with 14% still smoking in the year before surgery, which fell to 2% in the month before surgery. The rate rebounded to nearly 10% in the year following surgery and steadily climbed back to 14% by seven years post-surgery. 

 

“Interestingly, the people who picked up smoking post-surgery weren’t just the people who quit smoking in the year prior to surgery, presumably to prepare for the operation. Many had never smoked to begin with,” said co-author Gretchen White, Ph.D., assistant professor in Pitt’s School of Medicine, explaining that 2 out of 5 people who smoked after surgery had quit more than a year before their operation or hadn’t ever smoked. 

 

Additionally, people who identified as smokers post-surgery smoked more, going from an average of a dozen cigarettes per day in the year before surgery to more than 15 cigarettes per day seven years post-surgery.  These findings contrast with concurrent reductions in smoking prevalence and intensity in the general U.S. population. 

 

The researchers hypothesized that weight control would be a key reason weight-loss patients took up smoking after surgery, but found that the prevalence of smoking for weight control was actually fairly stable over time, at about 2% pre- and post-surgery, and did not appear to be related to smoking more cigarettes. King noted that “this surprised everyone, as there is a general assumption that weight control is a main motivator for smoking.”

 

While the study was not designed to find a biological reason for the results, the researchers did observe that gastric bypass patients were more likely to smoke post-surgery than patients who underwent gastric banding, where a silicone belt is surgically inserted around the stomach to reduce the amount of food it can hold. A recent study showed that gastric bypass increases exposure to the psychoactive nicotine metabolite cotinine. Just as gastric bypass increases the risk of alcohol use disorder due to changes in alcohol metabolism that lead to higher and quicker elevation of blood alcohol levels, it may also increase risk of smoking via nicotine metabolism, King suggested. 

 

The scientists identified several factors that predict which patients would be most likely to take up smoking after surgery. Not surprisingly, a prior history of smoking was the greatest risk factor. In addition, younger age, poverty, being married or living as married, and drug use were each associated with increased risk. 

 

The senior author on this research is Anita P. Courcoulas, M.D. Additional authors are Steven H. Belle, Ph.D., and Bestoun Ahmed, M.D., both of Pitt; Susan Z. Yanovski, M.D., of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Alfons Pomp, M.D., of Weill Cornell Medical College; and Bruce M. Wolfe, M.D., of Oregon Health & Sciences University. 

 

This clinical study was a cooperative agreement funded by the NIDDK. Grant numbers are: Data Coordinating Center – U01 DK066557; Columbia-Presbyterian – U01-DK66667 (in collaboration with Cornell University Medical Center CTSC, grant UL1-RR024996); University of Washington – U01-DK66568 (in collaboration with CTRC, grant M01RR-00037); Neuropsychiatric Research Institute – U01-DK66471; East Carolina University – U01-DK66526; UPMC – U01-DK66585 (in collaboration with CTRC, grant UL1-RR024153); and Oregon Health & Science University – U01-DK66555. 
GRAPHIC INFO: (click image for high-res version)

CAPTION:

CREDIT:

UPMC
200 Lothrop Street Pittsburgh, PA 15213

412-647-8762 800-533-8762

Patients And Visitors
  • Find a Doctor
  • Locations
  • Pay a Bill
  • Patient & Visitor Resources
  • Disabilities Resource Center
  • Services
  • Medical Records
  • No Surprises Act
  • Price Transparency
  • Financial Assistance
  • Classes & Events
  • Health Library
Health Care Professionals
  • Physician Information
  • Resources
  • Education & Training
  • Departments
  • Credentialing
Newsroom
  • Newsroom Home
  • Inside Life Changing Medicine Blog
  • News Releases
About
  • Why UPMC
  • Facts & Stats
  • Supply Chain Management
  • Community Commitment
  • Financials
  • Supporting UPMC
  • HealthBeat Blog
  • UPMC Apps
  • UPMC Enterprises
  • UPMC Health Plan
  • UPMC International
  • Nondiscrimination Policy
Life changing is...
Follow UPMC
  • Contact Us
  • Website/Email Terms of Use
  • Medical Advice Disclaimer
  • Privacy Information
  • Active Privacy Alerts
  • Sitemap
© 2025 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences Supplemental content provided by Healthwise, Incorporated. To learn more, visit healthwise.org
Find Care
Providers
Video Visit
Portal Login

Chat Keywords List

  • cancel or exit: Stops your conversation
  • start over: Restarts your current scenario
  • help: Shows what this bot can do
  • terms: Shows terms of use and privacy statement
  • feedback: Give us feedback
Continue
Chat with UPMC
RESTART
MENU
CLOSE