Preventing postsmoking cessation weight gain: exercise helps, even if previously inactive

Abstract

Smoking cessation is associated with weight gain, which may deter smokers from quitting and leads to questions about net benefit on subsequent health, given the link between weight gain and conditions such as cardiovascular disease. A recent large study addressed the health-related merits of smoking cessation, using pooled analyses of data from the Nurses Health Study, Nurses Health Study 2, and the Health Professionals Follow-up Study.1 In these three cohorts, almost three out of four participants gained weight after smoking cessation. In addition, compared with those who continued to smoke, quitters had a 22% higher risk of type 2 diabetes, with higher risk among those gaining more weight—those with no weight gain did not differ from continuing smokers, but excess risk climbed steadily with weight gain, from 15% for those gaining no more than 5 kg to 59% for those gaining more than 10 kg. This increase in risk, however, peaked around 6 years after cessation. Moreover, cardiovascular and all-cause mortality were 52% and 42% lower, respectively, in those who quit smoking than in those who continued to smoke. Even for quitters who gained more than 10 kg, cardiovascular mortality risk was 67% lower and all-cause mortality was 50% lower than in continuing smokers. These results demonstrate the overall utility of smoking cessation, and suggest that health-related benefits of smoking cessation are maximized by minimizing postcessation weight gain.