Smoking and
weight gain
Information for staff in social
and community services
Many women put off quitting smoking because
of concerns about weight gain.1 This fact sheet
explains the issues around quitting and weight
gain, and provides suggestions for how you can
help women who are considering quitting.
Concerns about weight gain
Concerns regarding weight gain are common in relation to
smoking cessation. It has been found that smokers have
about 10% higher metabolic rate than non-smokers and they
generally weigh less than non-smokers.2 Women sometimes
start smoking as a weight-control method, and concern about
weight gain after quitting smoking is often a reason why some
women recommence smoking.3
Smoking and weight gain
Key points about
weight gain
There are wide variations in the amount of weight gained
by people quitting smoking. A recent report on research
studies into quitting and weight gain found that most
smokers will gain weight after quitting in the first three
months, but this rate of weight gain then reduces.
At 12 months after quitting, it was reported that
16–21% of quitters had lost weight.4 Increase in waist
circumference per kilogram gained is smaller in people
who quit than in those who continue to smoke. Recent
ex-smokers gain less fat around their stomach (a risk
factor for cardiovascular disease) than those who
continue to smoke.5
How smoking affects weight
Nicotine speeds up the body’s metabolism. Therefore,
when a smoker quits there is a slowing of the metabolic
rate and more kilojoules are converted into fat.6 Nicotine
also decreases appetite and sustains the body when it
has low energy due to hunger. Weight gain after quitting
may also be influenced by increases in food intake.5 This
is because for some smokers trying to quit, the absence
of nicotine increases the rewarding value of food.6
Smoking appears to change the distribution of fat
in women, and women smokers tend to put on
more weight around their waists compared to those
women who do not smoke. Weight gain in this area is
associated with higher risk of stroke, heart disease and
type 2 diabetes, and a general increase in death rate.6
Benefits of quitting
The health benefits of smoking cessation far outweigh
the health risk from extra body weight5, and if a smoker
is already overweight, smoking is increasing the risk of
suffering from a range of other serious health problems.7
Over time, former smokers have a mean waist-to-hip
ratio and a mean body mass index (BMI) similar to or
approaching that of people who have never smoked.5
When a woman quits smoking, some weight gain can
be expected: however, it is less of a health risk because
it is not deposited around the waist, where it would be
associated with increased risk of heart disease.8
As well, quitting smoking increases fitness levels,
improves the appearance of skin and hair, and reduces
wrinkles – and teeth become whiter.9
Ways to manage weight gain
Research has found that behavioural treatments tailored
to the individual, such as very low-calorie diets and
cognitive behavioural therapy, may limit weight gain and
increase success in long-term quitting. As well, smoking
cessation pharmacotherapies such as bupropion and
nicotine replacement therapy (NRT) have also been
found to limit weight gain during treatment.1 However,
it is important that smokers focus on quitting smoking
before they become concerned with managing their
weight. Sequential behavioural treatment (cessation,
then diet and activity change) is more effective than
simultaneous treatment, because it is less overwhelming
to the individual.1
Advice that may help the individual quit smoking and
manage their weight includes:
• Noting the times when cigarette cravings or urges to
smoke or eat occur, and having sugar-free chewing
gum or unshelled nuts nearby. This will help to keep
hands busy, and chewing helps to not eat as much.
• Advise clients to reduce alcohol intake.
• Encourage becoming more physically active, as doing
exercise not only helps with weight but also reduces
cigarette cravings. This can be as simple as going
for regular walks (such as at lunchtime), taking stairs
instead of a lift, and parking the car further away from
entrances to shops or work.
• Using NRT or other smoking cessation medications
available from a doctor can assist in managing
nicotine withdrawal symptoms and can also delay
weight gain.
Encourage
becoming more
physically active,
as doing exercise
not only helps with
weight but also
reduces cigarette
cravings.
Smoking and weight gain
Need help to quit?
• Doctors can advise about the most suitable options for
helping women with quitting and managing weight gain.
• The Quitline (13 7848, 13 QUIT) is a 24-hour, 7-daysa-week telephone service that offers free assistance
to smokers and former smokers wishing to speak to a
trained health professional about quitting or staying quit.
• The iCanQuit website: www.icanquit.com.au is an
interactive quit tool that allows smokers to share their
stories about previous, current or planned quit attempts
with others. It provides helpful hints on how to quit, as
well as a goal tracker and savings
calculator so that smokers can see how much money is saved by quitting.
References
1 Parsons A, Shraim M, Inglis J, Aveyard P, Hajek P. Interventions for
preventing weight gain after smoking cessation. (Review). The Cochrane
Collaboration. John Wiley & Sons Ltd.; 2009.
2 Jonsdottir D, Jonsdottir H. Does physical exercise in addition to a
multicomponent smoking cessation program increase abstinence rate
and suppress weight gain? An intervention study. Scand J Caring Sci.
2001;15(4):275-82.
3 US Department of Health and Human Services. Women and smoking:
a report of the Surgeon General. Atlanta, GA: Centre for Disease Control
and Prevention; 2001. Available from: http://www.ncbi.nlm.nih.gov/
books/NBK44303/
4 Aubin HJ, Farley A, Lycett D, Lahmek P, Aveyard P. Weight gain in
smokers after quitting cigarettes: a meta-analysis. BMJ. 2012 Jul
10;345:e4439. DOI: 10.1136/bmj.e4439.
7 Fiore MC, Jaen CR, Baker,TB. Treating tobacco use and dependence:
2008 update. Rockville, MD: US Department of Health and Human
Services. Public Health Service; 2008. Available from: http://www.ncbi.
nlm.nih.gov/books/NBK63952/
8 Lissner L, Bengtsson C, Lapidus L, Bjorkelund C. Smoking initiation and
cessation in relation to body fat distribution based on data from a study
of Swedish women. Am J Public Health. 1992;82(2):273-5.
9 US Department of Health and Human Services. You can control your
weight as you quit smoking. Bethesda, MD: National Institute of Diabetes
and Digestive and Kidney Diseases; 2010. NIH Publication Number No.
03–4159. Available from: http://win.niddk.nih.gov/publications/PDFs/
quitsmoking.pdf
5 Scollo MM, Winstanley MH, editors. Tobacco in Australia: facts
and issues. 4th ed. Melbourne: Cancer Council Victoria; 2012.
Available from: http://www.tobaccoinaustralia.org.au
CAN10475 07/13
6 Audrain-McGovern J, Benowitz NL. Cigarette smoking, nicotine and body
weight. Clin Pharmacol Ther. 2011;90(1):164-8.