Even though many smokers fear the weight gain that often comes with quitting, a new study suggests those extra pounds won't undo the health benefits of kicking the habit.
The study, of more than 3,200 U.S. adults, found that former smokers cut their risk of heart disease and stroke in half. And it did not matter if they gained weight after quitting.
"This gives reassurance to smokers that the benefits of quitting still far outweigh any small health risks that may come with weight gain," said Michael Fiore, M.D., founder of the Center for Tobacco Research and Intervention at the University of Wisconsin in Madison.
Research suggests that half of women and one-quarter of men who smoke worry about gaining weight if they try to quit.
"Weight gain is a common reason people cite for not quitting," said Dr. Fiore, who co-wrote an editorial that accompanied the study in the Journal of the American Medical Association.
The fear of weight gain may or may not be for health reasons, of course. Some smokers want to avoid extra pounds because of "cosmetic" concerns, said James Meigs, M.D., the senior author on the study and a physician at Massachusetts General Hospital.
But when it comes to cardiovascular health, Dr. Meigs added, the new findings show that weight gain is no excuse to resist quitting.
Dr. Fiore agreed. "Quitting is the best thing you can do for your health," he said.
The findings are based on 3,251 adults taking part in the Framingham Offspring Study, a long-term offshoot of the Framingham Heart Study. Within the time frame used, 1984 to 2011, the participants had health exams about every four years; at the outset, 31 percent were smokers, but by the last exam, that had dropped to 13 percent.
Over the study period, 631 people suffered a heart attack, stroke, heart failure or clogged leg arteries, or died from a cardiovascular cause. But former smokers had only half the risk of current smokers, even if they'd gained weight. And typically, they had gained weight, an average of 5 to 10 pounds in the few years after quitting.
"So the message is, yes, you can expect to gain weight in the first few years after quitting," Dr. Meigs said. "But you'll still cut your risk of cardiovascular disease in half."
The researchers also zeroed in on study participants with diabetes, a major risk factor for heart disease and stroke. They found that people who'd kicked the smoking habit had a similar risk reduction as former smokers without diabetes. But the finding was not statistically significant, which means it could be due to chance.
Dr. Meigs stressed, however, that the finding does not mean people with diabetes don't benefit from quitting. He blamed statistics: There simply were not enough people in the study who were smokers, had diabetes and suffered a heart problem to be able to get a statistically reliable finding.
And Dr. Meigs pointed out, for a smoker with a major health condition such as diabetes, it would be even more important to quit smoking.
But even if weight gain will not negate the heart benefits of quitting, many smokers may want to avoid it anyway. "And you can do some things to minimize it," Dr. Fiore said.
One would be to start exercising. "Build some more physical activity into your daily routine," he said. As a bonus, he added, research suggests that exercise can help take the edge off nicotine cravings.
Watching your diet is key, Dr. Fiore said, because smokers often turn to sugary, fatty foods during quit attempts. There is also evidence that nicotine gums and lozenges can help hold off weight gain. It's not clear why, but it may be because of the effects of nicotine on metabolism.
Dr. Fiore has received research support from Pfizer to study its smoking cessation drug Chantix. Some of Dr. Meigs' co-researchers on the work have ties to companies that make or are developing smoking cessation products. The study itself was funded by U.S. and Swiss government grants. The study was led by Carole Clair, M.D., of the University of Lausanne in Switzerland.