Smoking cessation and body weight

A great attention is presently paid to smoking cessation and pharmacotherapy combined with counselling has been found to achieve the highest rate of smoking cessation. Smoking cessation is associated with weight gain and this may reduce compliance in a subset of smokers. In a previous research we evaluated the efficacy of a combined Group Counselling therapy and Bupropion therapy and we identified some outcome predictors.The aim of the present study is to evaluate the effects of smoking cessation on body weight during a one-year follow-up period. From January 2001 to December 2005, 587 volunteers (263 males and 324 females) who wanted to quit smoking were recruited by our unit. After an individual motivational interview subjects started a Six-week Group Counselling Program (SGCP) for smoking cessation and ten days before the “quitting day” were asked to begin a seven-week pharmacotherapy consisting of 300 mg Bupropion SR/daily (BT). Prior to admission to the program subjects were submitted to a physical examination by the medical staff and underwent a structured interview about their smoking history. The amount of exhaled CO was taken as a further measure of the smoking habit. Some psychometric instruments were administered: the Fagerström Tolerance Questionnaire (FTQ), the Severity of Dependence Scale (SDS) and the Three Factor Eating Questionnaire (TFEQ). Subjects were called in by counsellors after 3, 6 and 12 months to check their current smoking habit and body weight. Of the 229 subjects who accepted BT only 115 subjects completed the seven-week cycle of therapy (BT-COMP group) whereas the remaining 114 subjects discontinued medication (BT-NONCOMP group) but continued to attend SGCP. According to a previous report (3) both BT groups achieved a higher abstinence rate if compared to the sole SGCP. At the one-year follow-up abstinence rates were 65.4% and 47.4% in BT-COMP and BT-NONCOMP groups, respectively, whereas 39.7% was the quit rate of the SGCP sole group. We evaluated the increasing body weight in the three groups of subjects (SGCP only, BT-COMP e BT NONCOMP) according to gender and to the results of the one-year abstinence. Subjects who did not smoke after 12 months (nonS) are compared with those who were still smokers (S). Females and males non-smokers revealed - at five-week abstinence and at one-year follow-up - a weight gain significantly higher if compared with S of the same sex. Several different studies have shown that a great many people believe that smoking helps control weight and ex-smokers risk weight gain. Unfortunately, this widespread opinion is an accurate one and contributes to making difficult to quit this dangerous habit. Eating more food, particularly more sweet food, and a decrease in metabolic rate are the main causes. Our data suggest that seven-week BT is not a protective factor in increasing body weight. Regular aerobic exercise and nutritional counselling may be helpful to minimize weight gain after quitting smoking. Psychometric measures seem to be weak predictors of weight gain.