Ten-year weight gain in smokers who quit, smokers who continued smoking and never smokers in the United States, NHANES 2003–2012

Abstract

Background/Objectives Weight gain after quitting smoking is a common concern for smokers and can discourage quit attempts. The purpose of this analysis was to describe the long term weight gain, smoking cessation attributable (SCA) weight gain and describe their relationship to cigarette consumption and body mass index (BMI) 10 years ago in a contemporary, nationally representative sample of smokers who continued to smoke and those who quit. Subjects/Methods 12,204 adults ≥ 36 years old were selected from the 2003-2012 National Health and Nutrition Examination Survey (NHANES). Ten year weight gain for never, continuing and former smokers (who quit 1-10 years ago) was calculated by body mass index (BMI) 10 years ago and cigarettes per day (CPD). SCA weight gain was calculated by taking the difference between the adjusted mean ten year weight gain of former smokers and that of continuing smokers. Results Mean ten year weight gain among continuing smokers was 3.5 kg versus 8.4 kg among former smokers; 4.9 kg of SCA weight gain. After Bonferroni correction, there was no significant difference in overall weight gain between continuing and former smokers of 1-14 CPD and SCA weight gain was lowest in this group (2.0 kg, CI: 0.3, 3.7). SCA weight gain was highest for former smokers of ≥25 CPD (10.3 kg, CI: 7.4, 13.2) and for those who were obese (7.1 kg, CI: 2.9, 11.3) mostly due to lower than average weight gain or weight loss among continuing smokers in these groups. Conclusions In a current, nationally representative sample, baseline BMI and CPD were important factors that contributed to the magnitude of long term weight gain following smoking cessation. Light to moderate smokers (<15 CPD) experienced little SCA weight gain while heavy smokers (≥25 CPD) and those who were obese prior to quitting experienced the most.

Self-administered nicotine differentially impacts body weight gain in obesity-prone and obesity-resistant rats

“…Weight gain in OP nicotine rats was comparable to both lean (Chow and OR saline groups), suggesting that nicotine exposure may prevent the development of obesity. This aligns with a report in humans demonstrating that obese smokers lose weight compared to normal weight smokers during smoking [19]. It is unclear why rats resistant to the development of obesity are also resistant to the weight-suppressive effects of nicotine.…”

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

“…Thus the results may not be generalizable to the majority of smokers, many of whom quit by themselves [13,14]. Observational studies have studied slightly longer periods ranging from 4 to11 years, and have estimated weight gains of 3 to 6 kg in quitters compared with continuing smokers [15-20]. A recent meta-analysis of population-based studies of weight gain post smoking-cessation found a mean difference between quitters and continuing smokers of 2.6 kg over an average of 5 years of follow-up [21].…”

Reducing nicotine exposure results in weight gain in smokers randomised to very low nicotine content cigarettes

“…Further, the rate of weight gain in former smokers returns to that of age-matched non-smoker controls following one year of smoking cessation (9). Veldheer et al (8) recently reported a positive correlation between CPD prior to quitting and ten-year post-cessation weight gain, indicating that a larger change in nicotine exposure results in more robust weight gain. Of note, the sample in the current report was overweight at baseline.…”

“…Of note, the sample in the current report was overweight at baseline. Obese and overweight smokers consume more CPD on average than normal weight smokers (8, 11), and therefore may be at risk for larger weight gain following nicotine reduction (8). Although cessation is associated with an overall increase in weight gain, the impact of quitting on weight gain varies, with approximately 16% of smokers losing weight and 10% gaining over 10 kg in one year (10).…”

“…Smokers weigh less than non-smokers and smoking cessation is typically accompanied by weight gain, on average, of 4.5 kg within a year of abstinence (8–10). As such, one consequence of a nicotine reduction policy may be weight gain among current smokers (11).…”