Smoking Cessation Associated With Weight Gain and Decreased Mortality Risk

Grey matter loss from smoking may be reversible, study finds
Grey matter loss from smoking may be reversible, study finds
The researchers examined the association between weight change after smoking cessation and the risk of cardiovascular diseases (CVD), type 2 diabetes, cancer, chronic obstructive pulmonary disease, and all-cause mortality.

Despite substantial weight gain after smoking cessation, quitters had a mortality benefit. These findings, from a cohort study, were published in JAMA Network Open.

The Household, Income, and Labour Dynamics in Australia survey data were used for this study. Yearly, individuals across Australia were surveyed for demographics, socioeconomics, and health status since 2001. Data from 2006 through 2014 were analyzed for this study. Smoking status and general health were assessed.

A total of 16,663 individuals were included in this analysis, of whom 48.5% were men aged mean 43.7 (standard deviation [SD], 16.3) years. Few individuals continued to smoke throughout the study (21.5%), nearly half never smoked (47.1%), and the remaining (31.4%) had quit.

Quitters were less likely to be high-risk drinkers (5.8% vs 10.8%) but more likely to consume above average discretionary (31.3% vs 23.3%) and core (35.6% vs 17.6%) foods compared with smokers.

Compared with individuals who continuously smoked, cessation associated with increased weight (b, 3.14; 95% CI, 1.39-4.87; P <.001) and BMI (b, 0.82; 95% CI, 0.21-1.44; P =.009), more so among those who quit >6 years ago (weight: b, 2.17; 95% CI, 0.81-3.52; P =.002; BMI: b, 1.24; 95% CI, 0.92-1.57; P <.001).

Weight gain after cessation from smoking did not significantly increase risk for cardiovascular disease (hazard ratio [HR], 0.85; 95% CI, 0.54-1.33; P =.48), type 2 diabetes (HR, 0.99; 95% CI, 0.78-1.30; P =.95), cancer (HR, 0.95; 95% CI, 0.64-1.41; P =.81), or chronic obstructive pulmonary disease (HR, 0.84; 95% CI, 0.24-1.24; P =.21).

Risk for mortality was decreased among never smokers (HR, 0.36; 95% CI, 0.21-0.59; P <.001) and former smokers (HR, 0.50; 95% CI, 0.30-0.81; P =.005) compared with continuous smokers.

This study may have been biased, as it was based on self-reporting. Longer-term outcomes may not be consistent with these data.

The study authors concluded that although cessation of smoking associated with a substantial increase in weight, mortality was reduced compared with continuous smokers.


Sahle BW, Chen W, Rawal LB, Renzaho AMN. Weight gain after smoking cessation and risk of major chronic diseases and mortality. JAMA Netw Open. Published online April 27, 2021. doi:10.1001/jamanetworkopen.2021.7044