期刊
BMJ-BRITISH MEDICAL JOURNAL
卷 345, 期 -, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmj.e4439
关键词
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资金
- UK Centre for Tobacco Control Studies
- Public Health Research Centre of Excellence of the UK Clinical Research Collaboration
- British Heart Foundation
- Cancer Research UK
- Economic and Social Research Council
- Medical Research Council
- Department of Health
- Department of Health under UK Clinical Research Collaboration
- National Institute for Health Research
- UK Centre of Tobacco Control Studies
- Pfizer
- McNeil
- GlaxoSmithKline
- Pierre-Fabre Sante
- Sanofi-Aventis
- Merck-Lipha
- Economic and Social Research Council [ES/G007489/1] Funding Source: researchfish
- National Institute for Health Research [SPCR-018] Funding Source: researchfish
Objective To describe weight gain and its variation in smokers who achieve prolonged abstinence for up to 12 months and who quit without treatment or use drugs to assist cessation. Design Meta-analysis. Data sources We searched the Central Register of Controlled Trials (CENTRAL) and trials listed in Cochrane reviews of smoking cessation interventions (nicotine replacement therapy, nicotinic partial agonists, antidepressants, and exercise) for randomised trials of first line treatments (nicotine replacement therapy, bupropion, and varenicline) and exercise that reported weight change. We also searched CENTRAL for trials of interventions for weight gain after cessation. Review methods Trials were included if they recorded weight change from baseline to follow-up in abstinent smokers. We used a random effects inverse variance model to calculate the mean and 95% confidence intervals and the mean of the standard deviation for weight change from baseline to one, two, three, six, and 12 months after quitting. We explored subgroup differences using random effects meta-regression. Results 62 studies were included. In untreated quitters, mean weight gain was 1.12 kg (95% confidence interval 0.76 to 1.47), 2.26 kg (1.98 to 2.54), 2.85 kg (2.42 to 3.28), 4.23 kg (3.69 to 4.77), and 4.67 kg (3.96 to 5.38) at one, two, three, six, and 12 months after quitting, respectively. Using the means and weighted standard deviations, we calculated that at 12 months after cessation, 16%, 37%, 34%, and 13% of untreated quitters lost weight, and gained less than 5 kg, gained 5-10 kg, and gained more than 10 kg, respectively. Estimates of weight gain were similar for people using different pharmacotherapies to support cessation. Estimates were also similar between people especially concerned about weight gain and those not concerned. Conclusion Smoking cessation is associated with a mean increase of 4-5 kg in body weight after 12 months of abstinence, and most weight gain occurs within three months of quitting. Variation in weight change is large, with about 16% of quitters losing weight and 13% gaining more than 10 kg.
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