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Smoking Cessation, Weight Change, Type 2 Diabetes, and Mortality
Yang Hu1, Geng Zong1, Gang Liu1
1From the Departments of Nutrition (Y.H., G.Z., G.L., W.C.W., F.B.H., Q.S.), Epidemiology (Y.H., M.W., W.C.W., J.E.M., F.B.H.), and Biostatistics (M.W., B.R.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine (M.W., W.C.W., J.E.M., F.B.H., Q.S.) and the Division of Preventive Medicine (J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School - all in Boston; and the Key Laboratory of Nutrition, Metabolism, and Food Safety, Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai (G.Z.), and the Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (A.P.) - both in China.
Weight gain after quitting smoking increases short-term type 2 diabetes risk but does not negate benefits for cardiovascular and overall mortality. Continued quitting is associated with reduced mortality risks, regardless of weight changes.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- Smoking cessation is crucial for health, but the impact of post-cessation weight gain on its benefits is debated.
- Understanding weight change effects is vital for comprehensive smoking cessation support.
Purpose of the Study:
- To investigate if weight gain after smoking cessation affects the health benefits of quitting.
- To assess the association between weight changes post-cessation and risks of type 2 diabetes, cardiovascular disease (CVD) mortality, and all-cause mortality.
Main Methods:
- Analysis of three US-based cohort studies with prospective assessment of smoking status and body weight.
- Estimation of risks for type 2 diabetes and mortality among former smokers based on weight changes after quitting.
Main Results:
- Recent quitters (2-6 years) showed a temporary increase in type 2 diabetes risk, proportional to weight gain, but not if weight remained stable.
- No temporary increase in mortality was observed for quitters, irrespective of weight change.
- Significant reductions in CVD and all-cause mortality were observed in quitters, with greater risk reductions associated with higher weight gain.
Conclusions:
- Weight gain accompanying smoking cessation is linked to a short-term rise in type 2 diabetes risk.
- Quitting smoking continues to provide substantial benefits in reducing cardiovascular and all-cause mortality, even with significant weight gain.
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