Abstract
There is a strong evidence correlate smoking cessation with weight again which adds to health risks. The causes can be biological and-or psychological, secondary to nicotine withdrawal or to common beliefs that smoking reduces weight. Tackling this issue is a many-sided effort. There should be a plane to encourage practicing exercises, working on dietary habit, and consideration of nicotine replacement treatment.
Introduction
Obesity and smoking are two major health risk factors. In the US, 22.5% of adult population smoke and 31% are obese (body mass index over 30) (Healton and others, 2006). Many studies reported overlie and correlation between cessation of smoking and weight gain. O’Hara and colleagues (1998) reported an average weight gain 2.7 to 3.6 kg one year after cessation of smoking. With 10 kg weight gain, the impact on the lungs and cardiovascular system risks the benefits gained by quitting smoking.
The problem is not only with long-term weight gain, short-term weight gain affects the individual’s blood pressure, serum lipid level and blood glucose level. Thus, whether post smoking cessation weight gain occurs over a short or a longtime, it is still a major health hazard (O’Hara and others, 1998).
The aim of this paper is to present, in brief, the correlation between smoking cessation and weigh gain from biological and psychological viewpoints.
Main body
The relation between smoking and weight is controversial. Chiolero and others (2008) inferred that nicotine increases energy using up and perhaps reduces appetite. Another factor is the common belief among population that smoking reduces body weight may have a psychological implication in smoking cessation related weight gain. As stated by Chiolero and others (2008), there are other studies that display heavy smokers have increased body weight than nonsmokers. Increase in body weight 10 years after smoking cessation ranges between 2.8-4.4 kg in males and 3.8-5 kg in females. Americans of African descent and abundant (heavy) smokers are at more risk. The impact can be discouraging smokers to stop smoking or increase risk of relapsing and smoking again (especially in females) (Chiolero and others, 2008).
Chiolero and others (2008) suggested three principle biological mechanisms for post smoking cessation weight gain. First increased calorie intake (especially on the short-term), levels of 250-300 kilocalorie a day are reported. Second is decrease in energy use up and physical activity in response to nicotine withdrawal. Third are changes in fat tissue metabolism and fat oxidation (changes in lipoprotein activity), besides changes in neuropeptides as leptin and neuropeptide-Y whose functions are to regulate energy use up and food (calorie) intake.
From a psychological view point, smoking cessation represents a trial to correct a high risk health behavior, however, paradoxically; weight gain represents a failure to correct unhealthy eating behavior. Ogden and others (2007) explained this paradox in the lights of restraint theory, which looks at the influence of inflicting a cognitive restraint on eating, thus; trying to eat less paradoxically leads to increased eating. The public impression that smoking reduces weight can be a determinant factor for post smoking cessation weight gain. Dieting in these cases may lead to preliminary control of weight but may not be successful in long-term (Ogden and others, 2007).
Chiolero and others (2008) explained this paradoxical behavior pattern based on the set-point theory. It suggests that change of body weight above or below the natural weight that one assumes ideal if provided with a balanced diet (set-point specific for every individual) are opposed by either changes in eating behavior or energy use up. Chiolero and others (2008) suggested that nicotine may lower that set point, so ex-smokers would return to their set point and take more calories resulting in weight gain.
Conclusion
Weight gain after cessation of smoking can be a serious health hazard. Prevention of this problem is by dietary intervention in the form of directing ex-smoker’s attention to healthy food and working on dietary habits rather than diet control. Encouraging mild to moderate exercise to continue overtime and short-term nicotine replacement therapy can be helpful.
References
Chiolero A., Faeh D., Paccaud, F., and Cornuz, J. (2008). Consequences of smoking for body weight, body fat distribution, and insulin resistance. A. J Clin Nutr, 87, 801-9.
Healton, C G, Vallone, D, McCausland, K et al (2006). Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis. BMJ 333, 25-26.
Ogden J, Karim L, Choudry, A, and Brown, K (2007). Understanding successful behaviour change: the role of intentions, attitude and motivations and the example of diet. Health Education Research, 22(3), 397-405.
O’Hara P, Connett, J, Lee, W, et al (1998). Early and late weight gain following smoking cessation in the Lung Health Study. American Journal of Epidemiology, 148 (9), 821-830.