Interventions for preventing weight gain after smoking cessation.

Area of Science:

• Addiction research
• Behavioral science
• Pharmacology

Background:

• Smoking cessation often leads to significant long-term weight gain (average 7 kg).
• Interventions are needed to address both smoking cessation and post-cessation weight management.
• Pharmacotherapies and other interventions may play a role in limiting weight gain.

Purpose of the Study:

• To review interventions specifically designed to aid smoking cessation and limit post-cessation weight gain.
• To review interventions that may plausibly affect weight post-cessation.
• To evaluate the effectiveness of various pharmacological and behavioral strategies.

Main Methods:

• Systematic review of Cochrane Tobacco Addiction Group's Specialized Register and selected Cochrane reviews.
• Inclusion of trials measuring weight and/or smoking cessation at specified follow-up points.
• Meta-analysis of smoking abstinence (risk ratio) and weight change (difference in weight change).

Main Results:

• Pharmacological interventions (dexfenfluramine, fluoxetine, PPA, naltrexone) reduced short-term weight gain, but effects were not maintained long-term.
• Individualized programs, very low-calorie diets, and CBT showed potential for reduced weight gain and maintained abstinence.
• Bupropion, fluoxetine, and nicotine replacement therapy (NRT) limited weight gain during treatment, with uncertain long-term effects.

Conclusions:

• General advice alone is ineffective; individualized interventions, VLCDs, and CBT may be effective without compromising abstinence.
• Exercise interventions may offer long-term weight gain reduction.
• Bupropion, fluoxetine, NRT, and varenicline reduce weight gain during use, but long-term maintenance effects require further investigation.