“Smoking cessation substantially reduces the risks of cardiovascular disease (CVD); however, quitting smoking is associated with a small number of adverse health consequences, weight gain being one of smokers’ major concerns,” said the background information in the article.

Obesity is also a risk factor for CVD, and the average weight gain in the six months after smoking cessation varies between 3kg and 6kg.

“The effect on CVD of potential weight gain following smoking cessation is not well understood,” the authors wrote. Therefore the study set out to determine whether the cardiovascular benefit of smoking cessation is greater than the increased risk caused by weight gain.

Dr Carole Clair of the University of Lausanne, Switzerland, and colleagues conducted a study to assess the association between four-year weight gain following smoking cessation and CVD event rate among adults with and without diabetes. The study included data from the Framingham Offspring Study collected from 1984 through 2011.

At each four-year examination, self-reported smoking status was assessed and categorised as smoker, recent quitter (less than four years), long-term quitter (more than four years), and non-smoker. Models were used to estimate the association between quitting smoking and six-year CVD events and to test whether four-year change in weight following smoking cessation modified the association between smoking cessation and CVD events.

Weight gain occurred over four years in participants without and with diabetes. Among participants without diabetes, recent quitters gained significantly more weight (median 2.7kg) than long-term quitters (0.9kg), smokers (0.9kg), and non-smokers (1.4kg). Among patients with diabetes, recent quitters also gained significantly more weight (3.6kg) than smokers (0.9kg), long-term quitters (no weight gain), and non-smokers (0.5g).

After an average follow-up of 25 years, 631 CVD events occurred among 3 251 participants. The researchers found that among participants without diabetes, the age- and sex-adjusted CVD incidence rates were lower for non-smokers, recent quitters, and long-term quitters, compared with smokers.

After adjustment for CVD risk factors, compared with smokers, recent quitters had a 53 percent lower risk for CVD and long-term quitters had a 54 percent lower risk for CVD; these associations had only a minimal change after further adjustment for weight change. “Among participants with diabetes, there were similar point estimates that did not reach statistical significance,” the authors write.

“In conclusion, among adults without diabetes, quitting smoking was associated with a lower risk of CVD compared with continuing smoking. There were qualitatively similar lower risks among participants with diabetes that did not reach statistical significance, possibly because of limited study power. Weight gain that occurred following smoking cessation was not associated with a reduction in the benefits of quitting smoking on CVD risk among adults without diabetes. This supports a net cardiovascular benefit of smoking cessation, despite subsequent weight gain,” the authors wrote.

Source: EurekAlert!