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Quitting smoking helps hearts, even with weight gain

Cigarette butts in an ashtray in Los Angeles, California, May 31, 2012. REUTERS/Jonathan Alcorn
Cigarette butts in an ashtray in Los Angeles, California, May 31, 2012. REUTERS/Jonathan Alcorn

By Genevra Pittman

NEW YORK (Reuters Health) - People who have quit smoking have a lower chance of suffering a heart attack or stroke than current smokers - even if they put on a few extra pounds in the process, according to a new study.

Although the long-term cardiovascular benefits of kicking the habit have been well-established, researchers said it's been unclear how the weight gain that often accompanies quitting fits into that picture.

"Weight gain is a real concern for smokers who want to quit and this might not only be an aesthetic one," Dr. Carole Clair, who worked on the new study, told Reuters Health in an email.

"Overweight and obesity are risk factors for coronary heart disease. And it has been a concern that especially among people already at risk for (cardiovascular disease) weight gain following smoking cessation might cancel or at least decrease the benefits of smoking cessation," said Clair, from the University of Lausanne in Switzerland and Massachusetts General Hospital in Boston.

Smokers' heart rate and other body functions are revved up by nicotine, which may cause them to burn slightly more calories than nonsmokers - so when they quit, their metabolisms slow down. And recent quitters tend to compensate for nicotine withdrawal by snacking, according to Clair, hence the weight gain.

She and her colleagues analyzed data from a long-term study of 3,251 people who took health surveys every four years between 1984 and 2011. At the onset, just under one-third of those participants were smokers.

Over an average of 25 years, 631 of all participants suffered a heart attack or stroke or developed heart failure or another type of cardiovascular disease.

Both people who said they'd quit smoking since their last check-in and longer-term quitters were about half as likely to have heart problems as those who were still using cigarettes.

Quitters gained an average of six to eight pounds after kicking the habit, consistent with past research. But quit-related weight gain had no clear effect on cardiovascular health, the research team wrote Tuesday in the Journal of the American Medical Association.

"It's an understandable concern - might that weight gain offset the benefits that are known for quitting smoking?" said Dr. Michael Fiore from the University of Wisconsin School of Medicine and Public Health in Madison, who co-wrote a commentary published with the study.

"This is a good news story," he said. "You can be assured that if you quit smoking, even with a little bit of weight gain, you're going to achieve important health benefits."

In their commentary, he and colleague Timothy Baker point out that the new study couldn't zero in on the small proportion of people who gain more than 20 pounds during a quit attempt. It's possible those former smokers might still be at risk for health problems tied to weight gain.

Even if adding a few pounds seems to be okay heart-wise, Fiore said there are steps quitters can take to try to keep off any extra weight.

"We know that nicotine is an appetite suppressant, and when people quit smoking they often have an urge to eat more food. What we need to do is ensure that the foods we're eating are low-fat, low-calorie foods," he told Reuters Health.

In addition, "If you just build a little more exercise into your daily routine, you can blunt the weight gain." Nicotine gums or lozenges may also help keep overeating under control, he added.

According to the U.S. Centers for Disease Control and Prevention, about 19 percent of American adults are smokers. In 2010, just over half of those smokers tried to kick the habit. Many people try quitting a number of times before they're successful.

SOURCE: http://bit.ly/JjFzqx Journal of the American Medical Association, online March 12, 2013.

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