One in four smokers who receive heart transplants start smoking again after their surgery, according to a study by British researchers.

The Daily Mail reported March 31 that researchers who gathered evidence on post-surgical tobacco use by studying the presence of nicotine markers in urine samples found that 104 of the 380 male transplant patients studied resumed smoking. The study from Freeman Hospital in Newcastle, England found that those who resumed smoking lived an average of 11.89 years after their transplant surgery, four years less than those who didn't go back to smoking.

"Our findings should be a powerful deterrent to patients from returning to smoking post-transplant," the authors wrote. "We hope it will aid those counseling patients, both before and after transplant."

"Half of those on the heart transplant list die while waiting," said Londoner John Fisher, 46, who received a heart transplant in 2000. "A further one in five dies during or shortly after the operation. If you survive a transplant operation you owe it to your family, your donor's family and especially to the other people waiting for a transplant to promote transplantation in a positive way."

The study was published in the April 2008 issue of the American Journal of Transplantation.