【Purpose】We aimed to find the effects on health expenditures in gastric cancer surgery cases where there was preoperative smoking cessation.
【Methods】The subjects were ninety-seven patients with gastric cancer who underwent open distal gastrectomies from January 2011 to December 2016 in our department. Initially, we divided them into smokers and never-smokers and compared their relative health expenditures. Next, smokers were further divided into three sub-groups according to their smoking status: (1) ex-smokers (i.e., those who stopped smoking long before surgery), (2) recent non-smokers (i.e., those who stopped smoking shortly before surgery) and (3) current smokers (i.e., those who continued smoking). Then, the three groups were compared. In our department, we used the DPC (diagnosis procedure combination) system, so the comparison was examined piecemeal, with comprehensive points and gross pay points calculated by DPC.
【Results】Compared to never-smokers, healthcare expenditure were found to be high for smokers in terms of gross pay points and comprehensive points (p = 0.03 and p = 0.078, respectively). Healthcare expenditures were higher for ex-smokers and current smokers in terms of gross pay points and comprehensive points, compared to recent non-smokers. Moreover, the expenditures of recent non-smokers were the same as those for one who had never smoked.
【Conclusion】Gastric cancer patients smoking during the preoperative period ran the risk of higher medical costs. However, preoperative smoking cessation caused medical costs for recent smokers to decrease, arriving at the same level as never-smokers do. Thus, we should tell patients prior to surgery the importance of stopping smoking.

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