Weight gain in smokers after quitting cigarettes: meta-analysis
British Medical Journal, 08/02/2012
Aubin HJ et al. – 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.Methods
- A meta–analysis.
- Authors 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.
- They also searched CENTRAL for trials of interventions for weight gain after cessation.
- Trials were included if they recorded weight change from baseline to follow–up in abstinent smokers.
- They 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.
- They explored subgroup differences using random effects meta–regression.
- 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, authors 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.