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Smoking and Tobacco

What does using snuff do before surgury?

04/30/2007

Question:

My 20 year old son is having surgury May 30 on his knee. He is a snuff user. I would like to know why he can`t use snuff before surgury? The medical reasons? And the medical reasons why he should not use after surgury? He tries to quit but so far hasn`t. I will show him your medical answer. My father died of COPD. I do not want to do that again. I hope you can give me medical advice. Thank you,

My son is a very handsome young man.

Answer:

You bring up several good questions and important topics. Let's start with snuff. Snuff comes in a variety of forms, and I'm not sure which kind your son uses. The original snuff was powdered tobacco leaves that were either placed in the nose or inhaled. Your son is unlikely to be doing that. I also presume he is not using regular chewing tobacco (Red Man, Mail Pouch, etc.) Probably he uses American moist snuff (Copenhagen, Skoal, Kodiak, etc.) which is placed between the cheek and gum - sometimes in a small prefilled packet (Skoal Bandits, etc.).

All of these oral tobacco products are collectively known as "spit tobacco" because the irritation to the mouth causes users to drool or spit regularly. Unfortunately, that irritation also causes gum disease, tooth loss, halitosis, stained teeth, and even worse, mouth, tongue and throat cancer.

The good news is that snuff use is somewhat less risky than smoking as most of smoking's horrific effects on the lungs and cardiovascular system are comparatively diminished. The bad news: because venous nicotine levels can actually be higher in long-term snuff users, the grip of addiction can be very tough to overcome.

In addition to the health effects, snuff use is a strong marker for lack of education and low income potential. So in using snuff, your son thus labels himself to the outside world. Perhaps more importantly, recent surveys of teen and college-age girls show that the overwhelming majority of them will not kiss or date a boy who uses tobacco of any kind.

Back to your original question of why your son's surgeon doesn't want him to be "dipping" (using snuff) before his knee surgery. I suspect your doctor has seen the data showing that tobacco users (predominantly smokers) have much worse surgical outcomes: poor healing, infections, blood clots, tendon rupture, etc., than non-users. I don't think spit tobacco has been specifically studied. The surgeon also knows that good results in knee surgery depend on a strong commitment to a pretty tough rehab regimen. If your son can't quit at least for a week or so, maybe that commitment isn't there.

Rather than say more, let me leave you with a picture of a young spit tobacco user who developed mouth cancer and is about to lose his lower face. In this case, a picture is worth about a million words.

from Take a Close Look at What the Tobacco Industry Won't Show You

Good luck.

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Response by:

Rob  Crane, MD Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University