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 But any new health risks gained by putting on a few extra pounds are
overwhelmed by the health benefits of giving up tobacco, researchers
report in The New England Journal of Medicine.
The analysis found that weight gains up to 5 kg (11.02 lb) after
quitting raised the risk of developing diabetes by about 15 percent
compared to continuing smokers, and greater weight gains increased
the risk proportionately. But that risk began declining after five
to seven years to eventually match that of never-smokers.
"The more weight you gain, the more the risk. But the risk of
developing diabetes is short term," senior study author Dr. Qi Sun
of the Harvard T.H. Chan School of Public Health in Boston told
Reuters Health in a telephone interview.
"Even more importantly, regardless of how much weight quitters gain,
they really have a reduced risk of dying from cardiovascular
disease. This is very important for smokers to know," he said. "And
if they minimize their weight gain, they can maximize their
benefits."
"The cardiovascular and overall mortality benefits of stopping
smoking far outweigh the risks of acquiring type 2 diabetes," Dr.
Steven Schroeder of the University of California, San Francisco
agreed in a journal editorial.
While a weight gain of 5.1 kg (11.24 lb) to 10 kg (22.05 lb) by
recent quitters increased the odds of developing blood sugar
problems by 36 percent, for example, quitting smoking cut their odds
of death from heart attack, stroke and other cardiovascular disease
by 75 percent. Their odds of death from any cause were also 54
percent lower compared with continuing smokers.
Even a weight gain of more than 10 kg favored quitting. The risk of
diabetes rose 59 percent but the likelihood of death from heart and
stroke problems declined by 67 percent and the overall death rate
was cut by 50 percent.
With no weight gain, quitters' diabetes risk did not increase, but
their death rate from cardiovascular disease dropped by 53 percent
and the odds of death from any cause by 48 percent.
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Smoking itself was also linked to increased risk of type 2 diabetes.
People who had never smoked were 28 percent less likely to develop
blood sugar problems, the researchers found.
The study used health records from three large databases of
mostly-white doctors and nurses, with data going back to 1984.
Ultimately, the cases of 162,807 people were used to assess diabetes
risk and 170,723 were used to gauge mortality. Body weight was
logged over the first six years after quitting.
"It should be acknowledged," Schroeder writes in his editorial,
"that the participants in the three cohorts, all health
professionals, had health risks and behaviors that did not mirror
those of smokers in 2018, who tend to be concentrated among
vulnerable populations" such as minorities.
Thirty years after quitting, the odds of developing type 2 diabetes
were the same for former smokers as for people who had never smoked.
"In our analyses, we estimated that weight change within 6 years
after quitting explained 68.4 percent of the increased risk of type
2 diabetes," the researchers write. "Preventing excessive weight
gain may maximize the health benefits of smoking cessation through
reducing the short-term risk of diabetes and further lowering the
long-term risk of death."
About 16 percent of adults in the U.S., or nearly 38 million, smoke
cigarettes, according to the Centers for Disease Control and
Prevention.
SOURCE: https://bit.ly/2OXlGLP The New England Journal of Medicine,
online August 15, 2018.
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