Smokers are better off quitting, even though they’ll gain weight

Attention smokers: Have you been putting off quitting because you’re afraid you’ll gain weight? Do you tell yourself that those extra pounds will be just as damaging to your heart as cigarettes? A new study says it’s time to get real and kick the habit.

Yes, American smokers typically gain nine to 11 pounds in the first year after they quit. And yes, those extra pounds are hard to get rid of. It’s true that being obese – especially for people who have type 2 diabetes – can lead to complications from cardiovascular disease.

But a study published in Wednesday’s edition of the Journal of the American Medical Assn. concludes that those risks are far outweighed by the known benefits of smoking cessation.

Researchers analyzed data from 3,251 participants in the Framingham Heart Study who joined the landmark study as far back as 1971. Doctors checked in with them every four to six years. Between 1984 and 2011, there were a total of 11,148 examinations.

The overall prevalence of smoking dropped from 31% to 13% during that time, the researchers reported. Those who quit were much less likely to experience a “cardiovascular disease event,” such as a heart attack, stroke, congestive heart failure, peripheral artery disease or death.

After adjusting for the age and gender of study volunteers, the researchers found that smokers without diabetes experienced the most cardiovascular problems – a total of 5.89 “events” for every 100 examinations. Recent quitters had 3.22 such events and long-term quitters had 3.06 events per 100 examinations, and nonsmokers had only 2.43 events per 100 examinations.

Smokers also fared the worst among study volunteers with diabetes. After adjusting for age and gender, the researchers calculated that 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 story was similar when researchers zeroed in on heart attacks and coronary deaths. Among those without diabetes, there were 5.12 per 100 examinations, compared with 3.93 for recent quitters and 2.32 for long-term quitters. Among those with diabetes, there were 9.3 heart attacks or deaths per 100 examinations, versus 5.49 for recent quitters and 4.84 for long-term quitters.

Pulling it all together, the researchers found that people who quit smoking reduced their risk of serious heart problems by as much as 54%. And the overall trend suggested that those benefits offset the risks associated with weight gain among quitters who gained up to 11 pounds.

“Cigarette smoking has short- and long-term cardiovascular effects that are reversible shortly after cessation,” the study authors wrote. “Weight gain that occurred following smoking cessation was not associated with a reduction in the benefits of quitting smoking.”

In an editorial that accompanied the study, two experts from the Center for Tobacco Research and Intervention at the University of Wisconsin wrote that the data should be reassuring to smokers who want to quit but are concerned that the weight they’ll gain will just undo their efforts.

“The study supports the belief that smoking cessation is beneficial for smokers, and no subpopulation has yet been identified that shows significantly reduced benefit from quitting, let alone harm,” they wrote.

You can read the study online here and the editorial here.

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