Thursday, June 16, 2011

Weight! Quit Smoking Without the Gain

It is well established in the scientific literature that smokers generally weigh less than nonsmokers, and that smokers who quit are at risk for weight gain. A recent article in the journal Science (abstract here) reported that nicotine activates specific nerve cells in the section of the brain called the hypothalamus. This interaction may be responsible for decreased appetite; it is different from nicotine’s trigger of reward and satisfaction in the brain. This complex research was conducted in mice, so the results will need confirmation in human studies. Still, they substantiate two dreaded downsides to quitting smoking: the loss of the powerfully rewarding and satisfying activity, and the gain of unwanted pounds.

We already know that switching from cigarettes to smokeless tobacco keeps smokers satisfied while giving them almost all of the benefits of complete tobacco/nicotine abstinence. But does switching keep the weight off?

In 2004, I published the first and only research article answering this question (abstract here). Along with colleagues from UmeƄ University in Sweden, I used a World Health Organization dataset to evaluate weight gain among nearly 3,000 men in Northern Sweden.

Weight Gain Over Nine Years Among Men in Northern Sweden
Tobacco CategoryAverage (lbs)
Nonusers (Referent group) 7.0
Smokers 5.1
Smokers who quit completely 15.0*
Smokers who switched to snus 7.9
Snus users 6.8
Snus users who quit completely 11.2*
*significantly elevated compared with nonusers

The big gainers were smokers and snus users who became completely abstinent from nicotine and tobacco. But snus users and smokers who switched to snus didn’t gain any more weight than nonusers. This is important news for smokers who are concerned about putting on pounds when attempting to quit smoking.

I also noted that the rate of overweight at the start of the study was 32% among those who didn’t use tobacco, 29% among smokers, and 42% for ex-smokers. These percentages are somewhat lower than other reports because our group defined overweight as a body mass index (BMI) of 27 or higher. The standard definition of overweight starts at a BMI of 25. For more information about BMI, go to this website at the federal National Heart Lung and Blood Institute.

Fear of gaining weight should not deter smokers from quitting. Research shows that a switch to smoke-free tobacco can leave them healthier with no added pounds.

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