Interventions for preventing weight gain after smoking cessation.

Area of Science:

• Public Health
• Behavioral Science
• Pharmacology

Background:

• Weight gain is a common consequence of smoking cessation, potentially discouraging quit attempts and offsetting health benefits.
• Interventions to prevent post-cessation weight gain (PCWG) are being explored, but concerns exist about their impact on smoking cessation rates.

Purpose of the Study:

• To systematically review interventions targeting PCWG for their effects on weight change and smoking cessation.
• To evaluate interventions aiding smoking cessation that may influence PCWG.

Main Methods:

• Systematic review of randomized controlled trials.
• Searches included Cochrane Tobacco Addiction Group's Specialized Register, CENTRAL, and parent Cochrane reviews on smoking cessation interventions.
• Data extraction and meta-analysis were performed using standard Cochrane methods, focusing on weight change and smoking abstinence.

Main Results:

• Intermittent very low-calorie diets showed short-term weight reduction but no long-term benefit; one study suggested increased abstinence, another found no success.
• Interventions accepting weight gain had mixed effects on weight but increased quit rates at 6 months.
• Pharmacological interventions like dexfenfluramine, phenylpropanolamine, and naltrexone reduced weight gain short-term; bupropion and fluoxetine also limited weight gain.
• Nicotine replacement therapy (NRT) showed moderate certainty of weight reduction at end of treatment and possibly at 12 months.
• Exercise interventions showed minimal weight reduction short-term but significant reduction at 12 months.
• Varenicline showed modest short-term weight reduction but imprecise estimates for long-term effects.

Conclusions:

• No intervention demonstrated moderate certainty of clinically useful long-term weight gain reduction.
• There is no moderate- or high-certainty evidence that PCWG interventions negatively impact smoking cessation success.