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Risks of Quitting Smoking?

I'm trying to quit smoking, but I'm concerned about gaining weight if I succeed. I realize that smoking puts me at risk for heart disease, but so does obesity. Would I not be trading one risk for another?

Answer (Published 8/23/2013)

You raise a good question. It is common to gain weight when you quit smoking, an average of 6.6 to 13.2 pounds. If it occurs, this extra weight typically comes on within six months after you stop smoking and can be hard to shed. But results of a study published in the March 13, 2013 issue of the Journal of the American Medical Association suggest that the added weight doesn’t present the same risk of heart disease as smoking does. So you’re better off carrying some extra weight than continuing to smoke.

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The study looked at the association between smoking-cessation-related weight gain and disease risks, comparing them to the risks of continuing to smoke. The study population was 3,251 participants in the long-running Framingham Heart Study. Framingham doctors examined this group every four to six years between 1984 and 2011.

The data showed that those who quit smoking were much less likely to experience a heart attack or other heart problems, or stroke, or to die from a cardiovascular cause than those who continued to smoke. In smokers who did not have diabetes, there were 5.89 cardiovascular events for every 100 examinations. These events dropped dramatically among participants who had recently quit smoking – 3.22 for every 100 examinations. Among nonsmokers there were only 2.43 cardiovascular events in every 100 checkups.

Among participants with diabetes, smokers had 7.03 cardiovascular disease events per 100 examinations, compared with 6.11 for recent quitters, 6.53 for long-term quitters and 4.7 for nonsmokers.

The researchers found that participants who did not have diabetes and had quit smoking most recently gained six pounds compared to those who were long-term quitters (two pounds), smokers (1.9 pounds) and nonsmokers (three pounds). Those with diabetes who had quit smoking recently gained the most weight (7.9 pounds). Smokers with diabetes gained 1.9 pounds over four years, while long-term quitters with diabetes gained no weight and nonsmokers gained 1.1 pounds.

The good news for former smokers is that those who had quit recently had a 53 percent lower risk for cardiovascular disease, while long-term quitters had a 54 percent lower risk.

Overall, this study shows that quitting smoking reduces the risk of cardiovascular disease despite any weight gain. Quitting now will certainly provide cardiac benefits, and you would not be trading one risk for another.

Andrew Weil, M.D.

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