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Recommendation
| Recognize that smoking cessation may lead to weight gain or produce depressive symptoms.
- Weight gain:
- Smoking cessation is associated with a mean increase in weight of 5 kg
- Depression:
- Smoking cessation may produce depressive symptoms that are severe enough to warrant treatment, particularly in persons with a history of major depression
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Evidence:
- Weight gain:
- In a study of 5247 patients age 35 and older, it was found that persons who had quit smoking were significantly heavier than patients who smoked. Men who were former smokers were on average 4.4 kg heavier than men who continued smoking. Women who were former smokers were on average 5.0 kg heavier than women who continued smoking (70).
- Depression:
- A study enrolled 100 smokers with a history of major depression not currently requiring treatment in a 2-month smoking cessation program. The OR for an episode of major depression in patients who successfully quit compared to patients who did not was 7.17 (CI, 1.5 to 34.5) (71).
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Comments:
- Neither weight gain nor the risk of depression should discourage the initiation of smoking cessation interventions, although physicians should monitor for both.
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| Edward Ellerbeck, MD, MPH, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Kumanan Wilson, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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Smoking Cessation
> Effectiveness/Harms of Behavior Change on Clinical Outcomes
