A Weighty Problem for Ex-Smokers
Fear of weight gain is a reason smokers often give for not giving up the habit. And it’s a legitimate worry, say a growing number of researchers, some of whom used to pooh-pooh the excuse.
“Our research indicates that (fear of) weight gain was not only a major reason for self-reported relapse, particularly among women, but was a major barrier to future cessation attempts,” said Linda H. Eck, a registered dietitian at Memphis State University, who, with university psychologist Robert C. Klesges, polled more than 1,000 smokers.
In past years, Eck said, experts estimated that a third of smokers who quit would gain weight. Now, she said, Klesges and other experts predict that about 65% will put on pounds, although weight gain is insignificant for some.
Women ex-smokers may have a tougher time controlling weight than men. During a three-week study, Klesges and Eck evaluated the dietary habits of three groups: smokers, intermittent smokers (who for purposes of the study smoked one week, quit one week and smoked one week) and nonsmokers.
Studies Continuing
Women in the intermediate group ate more fats (after quitting), Eck said, and the women who quit smoking gained about 2.4 pounds a week. The men who quit gained less than a pound a week. The researchers are continuing to study eating habits after quitting cigarettes.
Eck said the Memphis findings are preliminary, but others are researching the weight problem.
The best way to minimize post-smoking weight gain? Nicotine gum could be one way, suggested Nina Schneider, a UCLA research psychologist specializing in smoking cessation. (Nicotine gum is only available by prescription in the United States, Schneider said.)
“Studies are showing there’s significantly less weight gain in people who use nicotine gum than in those who use placebos,” she said.
“Nicotine gum does alleviate hunger.”
In her own one-year study of 60 ex-smokers, half of the group used nicotine gum and the other half, placebo gum.
“During the first week of quitting, there was significant reduction in hunger in persons who used the active gum. And a recent study in another laboratory has shown that nicotine gum compared to placebo gum significantly reduced weight gain after 10 weeks of quitting.” Schneider, a former smoker, suggests ex-smokers use nicotine gum three to six months.
Medicine in Cars
The automobile glove compartment is a fine place to keep insurance information.
But not a good spot for prescription or over-the-counter medications, warns a Visalia physician who completed a pilot study of glove-compartment temperatures and found them surprisingly hot even during California winters.
“Temperatures in glove compartments from April to October in the Northern Hemisphere have been found to exceed outdoor temperatures by as much as 50 degrees Fahrenheit,” said Dr. Richard Seymour, a Visalia internist, “with the result that stored medications may be subjected to temperatures exceeding 150 degrees F.” Even in March, Seymour found glove-compartment temperatures hotter than 130 degrees on some afternoons; in mid-November, temperatures sometimes reached 110 degrees.
Seymour conducted his study after reading what he considers poor advice in a medical journal recommending drug storage in glove compartments. Using a standard thermometer, he took hundreds of temperature readings in his own car, a rental car and other parked vehicles over several warm months. After he tabulated the results of his one-man project, the American Medical Assn. published his findings in a letter in its journal this year.
“Excessive temperatures can reduce the potency of medication,” Seymour said. “The worst possibility is that a medication (exposed to high temperatures for a sufficient amount of time) might be chemically changed.”
“Most prescription and over-the-counter drugs should be stored between 59 and 86 degrees,” said Teresa Miller, a pharmacist and vice president of education for the California Pharmacists Assn. in Sacramento. “Above 104 degrees, many (medications) start to break down.”
“If you have to leave medication in a car,” Seymour said, “the floor is a better location . . . and an insulated container is advisable.”
There is no need to buy a special container, said Victor Boisseree, vice president for professional affairs for the pharmacists association: “A Thermos bottle is excellent. Put the whole container (of medication) in the Thermos.” On long car trips, he said, put the Thermos inside a cooler for further protection.
Morning-After Misery
For some, it’s the unwelcome sequel to the office Christmas party: the morning-after hangover.
Anyone who’s ever had one doesn’t need to hear the litany of possible symptoms: headache, fatigue, heartburn, nausea, dizziness, disordered sleep, sweating and palpitations.
“A hangover is the body’s way of detoxifying itself,” said Dr. Leon Marder, an associate professor of medicine and psychiatry at the USC School of Medicine and chief of psychiatry at Rancho Los Amigos Medical Center, Downey, who specializes in treating chemical dependencies. A hangover--a state of withdrawal--can strike even after relatively low alcohol ingestion, Marder said. “Some individuals may have a hangover from one drink,” Marder said.
Over the years, suggested hangover remedies have run the gamut, from the hair of the dog to jogging. And, while experts still don’t agree on the best approach, Marder and Gretchen Newmark, a Santa Monica registered dietitian, offer these tips to prevent or minimize the agony:
--Drink liquors with relatively low amounts of congeners, the natural products of the fermentation process, believed to play a role in hangovers. “The clearer the liquor, the fewer the congeners,” Marder said. “There are fewer congeners in gin and vodka than in rye whiskey, bourbon whiskey, brandy or cognac. And white wine has fewer than red.”
--Eat while you drink. “When you start drinking, eat something that contains fat because it stays in the stomach longer (than nonfat foods),” said Newmark. Good choices: cheese or buttery spreads. “Some people drink a glass of milk before they go (partying).”
What if a hangover strikes anyway? “The foolproof remedy is to stay quiet and rest the best you can, to give the body a chance to detoxify,” said Marder. Drinking plenty of fluids helps, too, both experts agreed.
“There is some new evidence that suggests that Vitamin C may modify the response to alcohol,” Marder said. Two suggested Vitamin C remedies: Take 5 grams of Vitamin C or 1/2 ounce of undiluted lemon juice before bed. “Vitamin C speeds the rate at which alcohol is oxidized and excreted by the body,” Marder said.
“I’d advise that if people use Vitamin C, it be a buffered form to reduce irritation to the stomach,” said Newmark.
The only way to prevent a hangover? “Don’t drink alcohol,” said Marder, who said he only drinks on rare occasions.
