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Weight gain in smokers after quitting cigarettes: meta-analysis

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e4439 (Published 10 July 2012) Cite this as: BMJ 2012;345:e4439
  1. Henri-Jean Aubin, professor of psychiatry and addiction medicine12,
  2. Amanda Farley, research fellow 3,
  3. Deborah Lycett, National Institute for Health Research school for primary care research fellow 3,
  4. Pierre Lahmek, gastroenterologist2,
  5. Paul Aveyard, professor of behavioural medicine 3
  1. 1Centre d’Enseignement, de Recherche et de Traitement des Addictions, Hôpital Paul Brousse, AP-HP, Univ Paris-Sud, INSERM U669, 94804 Villejuif, France
  2. 2Centre de Traitement des Addictions, Hôpital Emile Roux, Limeil-Brévannes, France
  3. 3UK Centre of Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
  1. Correspondence to: H-J Aubin henri-jean.aubin{at}pbr.aphp.fr
  • Accepted 17 May 2012

Abstract

Objective To describe weight gain and its variation in smokers who achieve prolonged abstinence for up to 12 months and who quit without treatment or use drugs to assist cessation.

Design Meta-analysis.

Data sources We searched the Central Register of Controlled Trials (CENTRAL) and trials listed in Cochrane reviews of smoking cessation interventions (nicotine replacement therapy, nicotinic partial agonists, antidepressants, and exercise) for randomised trials of first line treatments (nicotine replacement therapy, bupropion, and varenicline) and exercise that reported weight change. We also searched CENTRAL for trials of interventions for weight gain after cessation.

Review methods Trials were included if they recorded weight change from baseline to follow-up in abstinent smokers. We used a random effects inverse variance model to calculate the mean and 95% confidence intervals and the mean of the standard deviation for weight change from baseline to one, two, three, six, and 12 months after quitting. We explored subgroup differences using random effects meta-regression.

Results 62 studies were included. In untreated quitters, mean weight gain was 1.12 kg (95% confidence interval 0.76 to 1.47), 2.26 kg (1.98 to 2.54), 2.85 kg (2.42 to 3.28), 4.23 kg (3.69 to 4.77), and 4.67 kg (3.96 to 5.38) at one, two, three, six, and 12 months after quitting, respectively. Using the means and weighted standard deviations, we calculated that at 12 months after cessation, 16%, 37%, 34%, and 13% of untreated quitters lost weight, and gained less than 5 kg, gained 5-10 kg, and gained more than 10 kg, respectively. Estimates of weight gain were similar for people using different pharmacotherapies to support cessation. Estimates were also similar between people especially concerned about weight gain and those not concerned.

Conclusion Smoking cessation is associated with a mean increase of 4-5 kg in body weight after 12 months of abstinence, and most weight gain occurs within three months of quitting. Variation in weight change is large, with about 16% of quitters losing weight and 13% gaining more than 10 kg.

Footnotes

  • Contributors: H-JA, AF, PL, and PA contributed to the planning; all authors contributed to the drafting, revising, and final approval of the article; and H-JA, AF, and PA are responsible for the overall content as guarantors of the study.

  • Funding: The study received no special funding for this research. The team in the United Kingdom are funded by the UK Centre for Tobacco Control Studies, a Public Health Research Centre of Excellence of the UK Clinical Research Collaboration. The centre is funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the Department of Health, under the auspices of the UK Clinical Research Collaboration. PA is part funded by the National Institute for Health Research.

  • Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: support from the UK Centre of Tobacco Control Studies, British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, Department of Health, and National Institute for Health Research; H-JA has received sponsorship to attend scientific meetings, speaker honorariums, and consultancy fees from Pfizer, McNeil, GlaxoSmithKline, Pierre-Fabre Sante, Sanofi-Aventis, and Merck-Lipha; PA has done consultancy and research on behalf of the McNeil, Pfizer, and Celtic Biotechnology; no other relationships or activities that could appear to have influenced the submitted work.

  • Data sharing: No additional data available.

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