Effects of smoking cessation on β-cell function, insulin sensitivity, body weight, and appetite

Abstract

Objective: To stop smoking is commonly associated with significant weight gain, but the mechanisms for this are poorly understood. We assessed the effects of smoking cessation on body weight, insulin sensitivity, b-cell function, and appetite. Subjects and methods: Twenty-seven long-term smokers (nZ27; nine females/18 males, 28G1 years, 22.9G0.6 kg/m 2 )attending an ambulatory smoking cessation program in a community hospital in Vienna, Austria were examined at baseline (Visit A; still smoking) and after a minimum of 3 months of smoking abstinence (Visit B; nZ14); relapsed smokers were not followed up. Participants underwent 3-h oral glucose tolerance tests and body composition measurements at each study visit. Fasting (QUICKI) and dynamic (oral glucose insulin sensitivity (OGIS)) insulin sensitivity and b-cell secretion (insulinogenic index 140 (IGI40)) were calculated. Food intake was quantified with a free choice buffet. Fasting plasma concentrations of neuropeptide-Y (NPY), peptide-YY (PYY), glucagon-like peptide 1 (GLP1), leptin, ghrelin, and visfatin were measured. Results: After O3 months' smoking abstinence, body weight, and fat mass were increased (C4 and C22% respectively, P!0.05) and fasting insulin sensitivity deteriorated (QUICKI: post, 0.37G0.02 vs baseline, 0.41G0.2; P!0.05), while OGIS remained unchanged throughout. IGI40 increased by 31% after O3 months' smoking abstinence (P!0.01). Carbohydrate ingestion increased after stopping smoking (P!0.05). NPY fasting levels were increased after O3 months (P!0.05), PYY, GLP1, leptin, ghrelin, and visfatin were unchanged. Conclusion: Smoking cessation is associated with transient metabolic changes including increased b-cell secretion in response to glucose and fasting insulin resistance. These alterations may be associated with or contribute to the body weight gain after smoking cessation.

Smoking cessation and long-term weight gain in the Framingham Heart Study: an application of the parametric g-formula for a continuous outcome

“…Smoking cessation reduces the risk of cardiovascular disease (CVD) and increases life expectancy [2], but may also cause weight gain. This weight gain is a major reason for smoking recidivism and reduces incentives for smokers to quit [3,4] it may also lessen some of the health benefits of quitting smoking [5-9]. An accurate estimate of the long-term weight gain after smoking cessation is essential both for effectively designing weight-control interventions in those who quit smoking, and for assessing the potential risks associated with this weight gain.…”

Association Between Obesity and Cigarette Smoking: A Community-Based Study

“…Several studies have shown different impacts of smoking on obesity. Beside the fact that nicotine is associated with decreases in appetite and calorie intake, smoking also decreases capacity of individual to perform exercise due to impact on lung functions [1][2][3]. Due to the fact that smoking has different effects on obesity, different studies showed conflicting outcomes.…”

Changes in circulating leptin levels during the initial stage of cessation are associated with smoking relapse

“…Increased baseline circulating leptin also predicts higher self-reported cravings for cigarettes during smoking cessation, higher withdrawal symptoms, lower positive mood, higher distress and higher physical symptoms in smokers who have been abstinent for 24 hours (al’Absi et al 2011). Baseline leptin, however, has not been linked to relapse or abstinence following four weeks of smoking cessation (al’Absi et al 2011; Stadler et al 2014). While baseline leptin (during ad libitum smoking or smoking abstinence) may not be helpful in predicting relapse, the extent to which dynamic changes in leptin concentrations during the initial phase of a quit attempt relative to ad libitum are associated with subsequent cessation outcomes is not clear.…”