A recent study published in the September issue of Plastic and Reconstructive Surgery has revealed that plastic surgery patients who use marijuana also tend to have elevated nicotine levels, raising concerns about the potential underreporting of nicotine use in clinical settings.

The research, led by Dr. Yi-Hsueh Lu, M.D., Ph.D., from Montefiore Medical Center at the Albert Einstein College of Medicine, sought to assess marijuana and nicotine usage among plastic surgery patients. The study surveyed 135 patients who were seeking elective procedures at a single clinic, shedding light on the prevalence of substance use and its implications for surgical outcomes.

Key findings from the study revealed that 50% of the patients reported no substance use, while 19% were active nicotine users, 7% were active marijuana users, 13% used both nicotine and marijuana, and 11% were past users. Interestingly, among marijuana users who denied nicotine use, urine analysis detected significantly elevated nicotine (23.1 ng/mL) and cotinine (221.2 ng/mL) levels compared to nonusers.

Notably, fewer than one-third of active marijuana or nicotine users disclosed their substance use during clinical encounters, highlighting the challenge for healthcare providers in accurately assessing surgical risks. Despite the elevated nicotine levels in marijuana users, the study found no direct correlation between nicotine or cotinine levels and postoperative complications.

The authors expressed concerns about the underreporting of nicotine-containing product use, including marijuana, which could pose unrecognized risks in elective surgeries. "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 researchers noted. However, they also emphasized that no direct link between positive urine tests and negative surgical outcomes has been observed.

As plastic surgery continues to grow in popularity, the study underscores the need for better screening methods and patient transparency regarding substance use to ensure safer surgical practices.