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Nicotine, Marijuana Use Underreported by Plastic Surgery Patients

However, plastic surgery complications do not differ by urine test results

By Lori Solomon HealthDay Reporter

WEDNESDAY, Sept. 4, 2024 (HealthDay News) — Plastic surgery patients who use marijuana also have elevated nicotine levels, according to a study published in the September issue of Plastic and Reconstructive Surgery.

Yi-Hsueh Lu, M.D., Ph.D., from Montefiore Medical Center at the Albert Einstein College of Medicine in the Bronx, New York, and colleagues sought to understand marijuana and nicotine use in plastic surgery patients. The analysis included survey results from 135 consecutive patients presenting to a single clinic seeking elective procedures.

The researchers found that 50 percent were nonusers, 19 percent were active nicotine users, 7 percent were active marijuana users, 13 percent were active users of both, and 11 percent were past users. Among marijuana users who denied nicotine use, urine analyses showed significantly elevated nicotine and cotinine levels versus nonusers (average nicotine level, 23.1 ng/mL; average cotinine level, 221.2 ng/mL). During clinical encounters, fewer than one-third of active marijuana or nicotine users reported active use. Postoperative complications did not differ by nicotine or cotinine urine levels, reported use, or other patient characteristics.

“In clinical settings, underreporting of nicotine-containing product use, including marijuana, remains a concern for unrecognized surgical risk, and affects the decision on offering elective procedures,” the authors write. “Despite that, a correlation between a positive urine test result and negative surgical outcome has not been demonstrated.”

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