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A recent study has shown that electronic cigarettes (e-cigarettes) have been linked to post-surgical complications, although it is yet to be determined if the effects are similar to those caused by traditional cigarette use.

It is a well researched and known fact that the use of tobacco products, especially smoking of cigarettes, is directly related to post-surgical complications such as delayed wound healing and unfavourable outcomes in delicate procedures such as those performed in plastic and reconstructive surgery. These patients who smoke cigarettes are more likely to have problems with their skin grafts or flaps, which are performed for many types of plastic and reconstructive surgeries. These skin graft or flap complications are thought to be related to reductions in blood flow caused by nicotine and current journal entries have noted the potential complications that may be caused by nicotine in these tobacco products, especially in those patients who are smokers and who have had plastic surgery performed.

There has been a growing popularity in the use of electronic cigarettes which use electricity to vaporize the contents in the apparatus, which is liquid nitrogen that is flavoured to the user's preference. What is not known about these e-cigarettes is whether there are any health-related issues that are associated with their use. These concerns extend to whether these e-cigarettes are associated with any post-surgical complications, especially in plastic and reconstructive surgeries where positive outcomes rely heavily on a good blood supply of the wound bed of the patient or the donor tissue.

This concern regarding e-cigarettes was raised because of the increased risk of complications, after plastic and reconstructive surgery, in patients who smoked cigarettes. Since e-cigarettes use nicotine-containing solutions, which might lead to the mentioned skin flap issues, further research into the possibility of e-cigarettes causing this problem was warranted.

The research

Researchers looked at previous research papers that investigated the possible health-related effects that the use of electronic cigarettes, or "vaping", could have on a person. The aim of this research was to determine if there were any concerns regarding the topic and therefore make suggestions for patients undergoing plastic or reconstructive surgery who do "vape".

The findings

The researchers made the following deductions:

  • Using e-cigarettes seems to be a safer choice than cigarette smoking, and may even be helpful in patients who are trying to quit using tobacco products by acting as a substitute to slowly get away from being reliant on nicotine.
  • It's unclear what the chronic effects of inhaling nicotine vapour is, but there wasn't any evidence found that these chemicals resulted in the development of cardiovascular diseases or cancer like cigarette smoking does.
  • Since cigarette smoke also contains other chemicals and compounds that may cause restrictions in blood flow, the risk of e-cigarettes causing skin flap issues doesn't seem to be the same. However, there are queries regarding other possible hazardous toxins that may be found in electronic cigarette vapour. Clearly, further research is needed into these aspects.
  • In a previous study that was conducted on general surgery patients, it was found that abstaining from smoking for 3 or 4 weeks before surgery was performed, decreased the rate of post-surgical complications rate from 40% down to 20%.

The clinical significance

Based on this and their other findings, the researchers suggested that patients refrain from using their e-cigarettes for 4 weeks before plastic and reconstructive surgery is performed, even though it hasn't been determined yet if the effects are similar to cigarette smoking. It is recommended then that plastic and reconstructive surgeons advice their patients accordingly. 

Quitting Smoking

Tobacco cravings or the urge to smoke can be quite intense, but that doesn't mean that you can't stop using this product. This section of the article will focus on ways that can help you quit smoking, or at least help you resist the powerful urges to smoke.

Nicotine replacement therapy

Options for nicotine replacement products include:

  • An inhaler or nasal spray that needs a prescription.
  • Over-the-counter lozenges, gums or patches can help with overcoming cravings.
  • Non-nicotine prescription medications such as bupropion and varenicline.

Chewing

Keeping your mouth busy, by chewing sugar-free hard candy or gum for example, helps to fight the cravings for tobacco products. You can also chew on foods that are low in calories such as celery, carrot, sunflower seeds or nuts.

Avoid triggers

The strongest urge to smoke or use tobacco products occurs at places such as bars or parties, when drinking coffee or alcohol or while feeling stressed. It helps to identify these triggers so that you can either avoid them or have a plan to get through the scenario without using tobacco products.

Avoid having 'just one more'

Having just one cigarette results in your body getting stimulated with nicotine again. One become two, and two becomes the whole pack before you even realize it.

Delay

When you're busy experiencing a craving for tobacco products, try telling yourself to hold off for another 10 minutes or find something else to occupy your time with. This helps enough to get you through that craving episode and your body will want to carry on with other activities.

Incorporate relaxation techniques

Smoking is a coping mechanism for stress in most cases, so why not try swapping this for a more healthy alternative? Incorporating relaxation techniques such as massage therapy, yoga, meditation, listening to calming music and deep-breathing exercises help to reduce stress levels and thereby reduce cravings for cigarettes.

Become physically active

Just like relaxation techniques, physical activities can help reduce stress levels and distract you from tobacco cravings. You don't have to go and get a gym membership because even short bursts of physical activity such as running in place, doing push-ups and squats and running up and down stairs a few times can help. If physical exertion is not for you, then even performing activities such as needle-work or wood-work at home to keep you busy works as well.

Try getting support online

Try joining an online stop-smoking programme or read blogs from ex-smokers mentioning their journeys to quitting tobacco products. Reading messages from people you can relate to helps to motivate you to stop smoking.

Phone a friend

Phoning a friend, support member from a group or family member helps to talk about your craving and receive support so that you don't go back to smoking. It helps to get into a conversation with another person going through the same issue so that you realize that what you're doing is for your benefit.

Remind yourself of the benefits

Speaking of realizing that what you're doing is for your benefit, quitting smoking improves a person's mortality rate immeasurably. Since smoking leads to cardiovascular diseases and complications, as well as certain cancers, there is definitely no benefit to using tobacco products. It helps to write down the benefits of quitting smoking and then repeating them to yourself. This helps to reinforce the message.

Benefits of quitting smoking include:

  • Getting healthier and improving your quality of life.
  • Feeling better by breathing easier and not having a morning cough, for example.
  • Sparing your loved ones from secondhand smoke, which causes health-related issues too.
  • Saving money

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