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Abstract
Objectives Most people gain weight on stopping smoking but the extent of weight gain varies greatly. Interventions aimed at all quitters to prevent weight gain on cessation have proven unpopular but targeting people who have gained excess weight immediately after quitting may improve uptake and cost-effectiveness. We examined whether early large postcessation weight gain predicts overall large weight gain.
Design Retrospective cohort study.
Setting Primary care setting—smoking cessation centre in Prague, Czech Republic.
Participants Out of 3537 patients treated between 2005 and 2013, 1050 were continuous abstainers (verified by carbon monoxide measurement) at 1-year follow-up and formed the cohort of the current report. 48.7% were women (n=511) with the mean age of 46 (±14.4) years.
Methods In this retrospective cohort study, all patients underwent usual tobacco dependence treatment using evidence-based methods. Weight was measured prior to smoking cessation and at each visit after quitting.
Results The mean weight gain in the first month (n=763) was 0.79% (±2.03%), in the second month (n=646) was 1.49% (±2.58%), for the third month (n=566) 2.33% (±3.44%) and 4.1% (±5.31%) after 1-year follow-up (n=1050). The regression coefficient per 1% rise in the first 3 months was +0.13% (95% CI −0.04% to 0.30%). A receiver operating curve analysis showed that patients gaining more than 0.98% of their baseline weight during first 3 months had a sensitivity of 66% and specificity of 44% for gaining 7% or more weight by 12 months. In addition, lower body mass index and an increase in appetite at 3 months after quitting were associated with greater weight gain, while using nicotine replacement therapy was associated with less weight gain at 1-year follow-up.
Conclusions People who stop smoking and gain a larger amount of weight early after quitting are not more likely to gain excessively at 1 year.
- smoking
- smoking cessation
- weight
- weight gain
- body weight changes
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Footnotes
Contributors AP and PA designed the study and wrote the protocol. LS and KZ conducted literature searches and provided summaries of previous research studies. PO and MB conducted the statistical analysis. EK wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript.
Funding This work was supported by the Charles University’ institutional support, project PROGRES Q25/LF1. PA is an NIHR senior investigator and is funded by NIHR Oxford Biomedical Research Centre and the CLAHRC.
Disclaimer The views expressed are not necessarily those of the NIHR, NHS, or Department of Health.
Competing interests AP, EK, LS and KZ received payments for clinical studies and educational activities from pharmaceutical companies producing smoking cessation medication.
Patient consent Obtained.
Ethics approval Ethics Committee of the General University Hospital in Prague.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.