Credit: Unsplash/CC0 Public Domain Marijuana use is common among patients considering plastic surgery and is associated with elevated nicotine levels on laboratory tests, reports a paper in the September issue of Plastic and Reconstructive Surgery .
"We found that patients who report marijuana use also have elevated urine nicotine and cotinine levels—even those who don’t smoke or use other nicotine-containing products" comments ASPS Member Surgeon Joseph A. Ricci of Hofstra University School of Medicine, Great Neck, NY. "This raises concerns that unsuspected nicotine exposure might lead to an increased risk of postoperative complications."
The rising prevalence of marijuana use raises questions about potential negative effects in patients undergoing surgery . Marijuana smoke contains carcinogens and irritants similar to those in tobacco smoke , with similarly harmful effects on pulmonary health.
Nicotine causes impaired wound healing, which is a special concern in patients undergoing plastic surgery . The rising popularity of marijuana, combined with newer nicotine delivery products such as vapes, "presents a clinical challenge for health care providers to identify patients who are exposed to nicotine, as patients themselves may be unaware," the researchers write.
Dr. Ricci and colleagues examined the possible link between marijuana use and nicotine exposure in 135 consecutive patients who consulted a surgeon to discuss cosmetic plastic surgery. Ninety-two percent of patients were women; the average age was 38 years. The patients were largely Hispanic, reflecting the demographics of the area served by the clinic. High nicotine levels raise ‘concern for unrecognized surgical risk’
In a survey, 19% of patients reported active nicotine use while 20% reported marijuana use: marijuana alone in 7% of patients and both nicotine and marijuana by 13%. Levels of nicotine and the nicotine metabolite cotinine were compared between groups.
The results showed elevated nicotine and cotinine levels among patients who said they used marijuana. The association was apparent not only in those who reported nicotine-containing products, but also in those who denied any type of nicotine use.
Although marijuana users had elevated nicotine, the levels weren’t as high as typically found in patients who smoke or use other forms of nicotine. Most patients who reported marijuana […]
Plastic surgery patients who use marijuana also have elevated nicotine levels