Helen
Hunt
Nicotine and its Effects on
Weight
Table of Contents
|
Nicotine’s
Effect on Weight |
|
|
Introduction |
|
|
Negative
Effects on Women |
|
|
Purpose
of Information |
|
|
Why
do some people gain weight? |
|
|
The
effects of nicotine on appetite |
|
|
Change
in Metabolism |
|
|
Effects
Smoking Cessation has on Body Weight and Plasma Leptin Levels |
|
|
Effects
of Nicotine on Rats |
|
|
Change
in Diet and Exercise Habits |
|
|
Lose
weight?? And Insulin Resistance |
|
|
Nicotine’s
Effects |
|
|
Ways
not to Gain Weight |
|
|
Aromatherapy:
A Way to Avoid Weight Gain? |
|
|
The
Menstrual Cycle and Avoiding a Large Amount of Weight Gain and Is
Menopause to Blame? |
|
|
Results
from the United Kingdom |
|
|
Avoid
Weight Gain the Healthy Way |
|
|
Conclusion
and References |
Introduction
Bad breath, yellow teeth, a chronic cough…these are some of the disgusting results of smoking cigarettes. Why do people continue to smoke when the effects are so harmful? The typical response from smokers to this question is that they smoke in order to relax and help relieve stress. Unfortunately, the quick fix happens to be an addictive narcotic. Smoking feeds the addiction, but it also feeds the body with about 40 cancer-causing chemicals as well as almost 4,000 other chemicals (http://www.pueblo.gsa.gov/cic_text/health/w8quit-smoke/index.htm). Besides the visible physical effects, smoking increases the risk of heart disease, stroke, cancer, emphysema, chronic bronchitis, and other lung diseases (http://www.pueblo.gsa.gov/cic_text/health/w8quit-smoke/index.htm).
With the first issuance of health warnings on cigarette packages being more
than thirty years ago, logically the number of American smokers should have
drastically decreased by now. However,
polls show that 32 million Americans continue to smoke according to the
American Dietetic Association website (http://www.eatright.org/erm/erm011200.html).
Those who continue to smoke, despite the health risks, have decided to take
chances with their long-term health rather than sacrifice the immediate
benefits of a cigarette. Many
current smokers say they are afraid to quit their destructive habit for fear
of weight gain associated with the cessation of smoking.
The added weight, however, poses a much lower health risk than the
continuation of smoking. In order
to reach equal health risks of smoking just one pack of cigarettes a day,
someone would have to be about 125 pounds overweight (http://www.quitsmoking.com/books/nonag/weightgain.htm).
Negative
Effects on Women
Furthermore,
the negative effects smoking has on women are especially grim.
A site devoted to women and smoking disclose that in the year 2000,
women and young girl smokers will have a higher morbidity and mortality rate
than that of men. Women smokers
have a smaller lung capacity than men, which makes females more vulnerable to
the chemicals in cigarette smoke. Also, women smokers have a four times greater chance of
developing cervical cancer than non-smokers.
Another frightening statistic mentioned in the article says that women
who smoked 40 or more cigarettes a day showed a 74% higher risk of developing
fatal breast cancer than non-smoking women.
Additionally, a woman who smokes has a six-times greater risk of heart
attack than men who smoke. Last,
women
are at a much higher risk for problems during pregnancy if they smoke. Their
babies are also put at risk of possible low birth weight, Sudden Infant Death
Syndrome,
birth defects, future asthma, lower respiratory tract infections, and ear
infections (http://www.bewell.com/healthy/woman/1998/smoking/index.asp).
Purpose
of Information
The
purpose of the plethora of information concerning the termination of smoking
induced weight gain is to inform web users of different ways of avoiding
weight gain after quitting smoking. To
some, the gain seems inevitable, but these sites attempt to change that
mindset by offering advice on diet and exercise, as well as some alternative
treatments. The majority of the advice given by the websites is pretty
standard advice for abstaining from weight gain, however there are a few
alternative treatments.
Why
do some people gain weight?
The
effects of nicotine on appetite
A typical question asked by smokers considering quitting is: Why do some people gain weight when they quit smoking? It all jumps back to the effects of the nicotine found in cigarettes. Nicotine curbs the appetite and triggers the liver to release glycogen, a substance that slightly increases the blood sugar level. Since cessation of smoking means nicotine is not entering the body, an ex-smoker might feel hungry more often. With smoking cessation, the body must readjust to a lower metabolic rate. If an ex-smoker eats the same amount of food as when he or she smoked, the body will end up using fewer calories and storing the extra calories as fat. Smoking also deadens the taste buds, so food will begin to taste better than before, which might account for more food intake. The last reason quitters might gain weight is because of oral fixation. Many ex-smokers desire something to put in their mouths instead of a cigarette, such as food! This contributes to the overeating of quitters (http://www.goaskalice.columbia.edu/0919.html).
The cause of weight gain is that nicotine keeps a smoker’s weight
low, and when someone quits smoking his or her body returns to the weight it
would have
been had the person never smoked. Also,
during the first week after quitting smoking, an ex-smoker might gain three to
five pounds due to water retention (http://www.pueblo.gsa.gov/cic_text/health/w8quit-smoke/index.htm).
According to the Best Health website provided by Wake Forest University
Baptist Medical Center, when a person quits smoking their body undergoes major
change, which includes better sense of smell and taste.
With this change, food may be appreciated more for its taste, which
could lead to overeating. Many
quitters also feel that high-fat foods are their “reward” for kicking
their nicotine habit. Foods high in fat content may partly suppress the craving for
nicotine, but will definitely cause additional weight gain (http://www.besthealth.com/wellness/ws6.html).
Change
in Metabolism
Another site discusses how it is the change in the smokers’ metabolism that leads to weight gain. Smoking increases the expenditure of calories, which makes it more difficult for the body to store fat, which accounts for a lower body weight for those who smoke. The site states that when smoking cessation occurs, more calories are converted into tissue, which is equivalent to weight gain (http://www.sk.lung.ca/smoking/b1.html).
Effects
Smoking Cessation has on Body Weight and Plasma Leptin Levels
A study printed in Metabolism explains the relationship between body weight and plasma leptin levels. It is a widely known fact that smokers weigh less than non-smokers of similar ages. Another fact is that smokers usually gain weight after quitting because of an increase in food intake and a decrease in energy expended. The magazine printed that nicotine has a direct effect on adipose tissue metabolism, which diverts fat storage away from adipose tissue during nicotine intake and affects the amount and rate of weight gain after quitting smoking.
Leptin, and endocrine signal, emerged as a protein product after the obese gene was cloned. Leptin is secreted by adipocytes and is believed to regulate body fat stores through hypothalamic control of energy intake and expenditure. The protein reduces food intake, increases energy expenditure, and decreases body weight in rodents. In people, circulation leptin concentrations and adipose tissue leptin gene expression are higher in obese humans. Both of these things increase with weight gain and decrease with weight loss. The study hypothesized that leptin has an effect on the weight-reducing effects of smoking. The study attempted to determine whether leptin has an effect on the weight reduction caused by smoking. The magazine stated that by measuring plasma leptin concentrations in 22 nonsmokers matched for age and BMI with 22 smokers they were able to determine whether the weight reducing effects of smoking may be mediated by leptin.
The study concluded that male smokers have a higher leptin level for a given
BMI than men who don’t smoke. Their
results showed that after six months of abstinence from smoking, body weight
increased by 7%. Even though
there is a noticeable weight gain, there was not an increase in the mean
leptin concentration after smoking cessation.
For most of the men, leptin levels were 25% lower than would be
expected for the amount of weight gained after quitting smoking.
The study concluded that cigarette smoking elevates the concentration
of circulating plasma leptin and this rise in concentration may be one cause
for the lower body weight of smokers (Nicklas, Tomoyasu, Muir, and Goldberg,
1999).
Another study printed in the American Journal of the Medical Sciences completely contradicted the study done by Metabolism. This study also investigated the effects of nicotine abstinence on plasma leptin concentrations and lipid metabolism in adult smokers. This study’s methods were to watch six non-obese adult smokers for seven days of nicotine abstinence. The smokers refrained from smoking overnight and then the subjects chewed nicotine polacrilex gum hourly from 7:00AM to 8:00PM. Blood samples were collected at 7:00AM and at 5:00PM on the nicotine intake day. Samples were again taken after seven days of nicotine abstinence. The results returned by the journal stated that nicotine abstinence for seven days did not affect body weight or circulating concentrations of leptin, glucose, insulin, or free fatty acids. However, the high-density lipoprotein (HDL) cholesterol increased dramatically after the nicotine abstinence. This study claims that changes in leptin circulation do not contribute to the weight gain associated with smoking cessation. However, in this study, the administrators did not directly measure leptin gene expression or the rates of leptin production by adipose tissue (Oeser, Goffaux, Snead, and Carlson).
Effects
of Nicotine on Rats
A study reported in the American Journal of Physiology discusses the effects
of nicotine on rats (Sztalryd, Hamilton, Horowitz, Johnson, and Kraemer,
1996). According to this study, the decrease in adiposity with
smoking seems to be caused by nicotine rather than other behaviors related to
smoking. The study looked at the
cellular mechanisms for lower adiposity seen with nicotine ingestion.
In the study, rats were given nicotine or saline for one week and
adipocytes isolated from epididymal fat pads.
The nicotine-infused rats gained 37% less weight and had 21% smaller
fat pads. The nicotine rats also
had a 30% decrease of their lipoprotein lipase (LPL) activity, but without any
changes in LPL mass or mRNA levels, in epidemymal fat in the fed stage.
Lipoprotein lipase is the enzyme, which hydrolyzes circulating
trigylceride-rich lipoproteins to fatty acids.
The study by Sztalryd et al. states, “Lipoprotein works as a
gatekeeper for trigylceride uptake by adipocytes” (1996, p. E216).
These results suggest nicotine diverts fat storage away from adipose
tissue and toward utilization by muscle.
The study concludes that nicotine does cause alterations in weight.
|
|
Change
in Diet and Exercise Habits
One site instructs those considering quitting smoking to become more physically active and change his or her eating habits prior to quitting smoking. They suggest at least thirty minutes of exercise most days. The site offers some simple ways to add exercise: gardening, housework, mowing the lawn, playing actively with children, and taking the stairs instead of the elevator. This site also tells a prospective ex-smoker the changes necessary in a diet in order to keep the weight gain off. It directs people towards grain products, vegetables, and fruits. People should also eat lean and low-fat foods and low-calorie beverages as frequently as possible. It commands abstinence from foods high in fat and sugars and low in nutrients (http://www.pueblo.gsa.gov/cic_text/health/w8quit-smoke/index.htm). A different source says to have a decent portion of starch food at meals such as rice, pasta, potatoes, or bread. These types of food will help fill the stomach, which makes someone less likely to snack between meals. Some more ideas are to use butter sparingly, have only small portions of cheese, and eat chicken, turkey and fish. These meats are especially low in fat when grilled, baked, or steamed. The article advocates avoiding snacking on foods such as chocolate, biscuits, cakes and nuts (http://www.quit.co.za/quithp/b1c.htm).
According to “walk talk” with Maggie Spilner, the walking editor for Prevention Magazine, one way to manage the weight gain is to watch the intake of food and to walk briskly five to seven days a week for about forty-five minutes to an hour. She mentions that it is alright to split the workout into two or three different sessions if an hour is too difficult all at one time (http://www.prevention.com/walking/qa/990929.qa2.html).
Another site mentions that ex-smokers who increased their physical activity as the site suggests only gained 4 pounds over a two-year period. A study conducted by Peggy O’Hara, which appeared in the American Journal of Epidemiology declares that without the increase in physical activity, men who quit gained an average of 16.7 pounds over a five-year period, and women permanently gained 19.2 pounds over the five-year period. The people in the study gained approximately 60-65% of the weight within the first year after giving up cigarettes. These men and women may have gained more weight than is common for most because they were heavy smokers. The website testifies that previous research findings say that the more people smoke, the more weight they will gain once they refrain from smoking (http://www.naturalland.com/wlv/wlnews/cab/bn1116.htm).
Lose
weight??? And Insulin Resistance
An additional site found on the internet claims it is common to gain about five pounds when someone quits smoking, and only 3% of ex-smokers gain more than twenty pounds. Also, the site asserts that one out of four quitters will actually lose weight when quitting. Another study showed that 23% of ex-smokers lost weight (http://www.quitsmoking.com/books/nonag/weightgain.htm). One study concluded that along with weight gain, smoking cessation is also responsible for improvement in insulin resistance. It further expresses that nicotine is the main ingredient causing insulin resistance, but an unknown chemical is responsible for the weight gain (http://www.clinicalcardiology.org/briefs/9905briefs/22-357.html).
It points out that nicotine in cigarettes fuels some of the same receptors in our brains, which respond to certain components in some weight-loss medicines pulled off the market because of cardiac side effects. The effect of nicotine, only one of the 4,000 chemicals in cigarettes, is so complicated that it may always be unclear as to why smokers gain weight when they quit. The site further states that quitting smoking reduces your metabolic rate by about ten percent. The columnist tells her writer to decrease her food intake by more than ten percent of what she was eating while smoking in order to lose weight. The column suggests increasing the level of aerobic exercise as much as possible, which includes jogging, speed walking, jumping rope, aerobics classes, and yoga. The best suggestion of the column is to refuse to start smoking again to lose weight (http://www.naturalland.com/wlv/wlnews/cab/qa54.htm).
Ways
to NOT gain weight
Another
site has several strategies to consider, with the first being to ignore the
fact that you might gain weight and just go ahead and quit smoking!
The next strategy is to exercise, but the site cautions trying to add
exercise to the daily routine after quitting smoking.
The article advises the smoker to start exercising before they attempt
to quit smoking. The
third strategy is to reduce sweets by instead eating fruit or using sugar
substitutes. An alternative
approach is to change your routine. The
suggestions are (1) to take smaller portions, (2) eat slowly and try to be the
last one finished, (3) put your fork down between bites, (4) drink a large
glass of water with each meal and take frequent sips between bites, (5) serve
fruit for dessert, or skip it altogether, (6) get up from the table as soon as
you are finished with your meal, (7) terminate your meal with a nonsmoking
activity such as washing the dishes, taking a walk, etc., (8) stock up on raw
vegetables for healthy snacks, (9) go to bed earlier in order to avoid late
night snacks. The last
proposition is to do something dramatic.
The article tells the story about one ex-smoker, “When I quit smoking
I gained twelve pounds. Determined
to lose it, I drove to a supermarket two miles from my home, marched up to the
butcher counter, and had them grind me twelve pounds of hamburger meat.
I left my car in the parking lot and carried it home.
By the time I got home I was exhausted.
I was carrying that much extra weight around with me everyday—no
wonder I felt tired all the time (http://www.quitsmoking.com/books/nonag/weightgain.htm).”
Aromatherapy:
A Way to Avoid Weight Gain?
One alternative treatment to abstain from weight gain associated with smoking cessation is aromatherapy. One product, Aroma Works—Suppress, claims to offer peppermint to increase digestion, fight weakness and relieve hunger headaches. It also advertises to helps boost confidence and optimism. This product states that the sense of smell is channeled by the olfactory nerve receptors, which is the only one of our senses directly connected to our brain. The receptor is located just below the brain and has tiny, cilia-like nerves that seize the aroma molecules surrounding us and sends the message directly to the brain’s limbic system, skipping by the blood/brain barrier. According to the commentary, “the limbic system is the “central command” of emotion and memory. The limbic controls the entire endocrine system of hormone production that regulate the body’s metabolism, stress responses, caloric levels, insulin balance, sexual arousal and much more.” The article points out that there are no known side effects of aromatherapy and the treatment is completely safe and non-habit forming. The company does suggest people under the care of a physician consult with them prior to using the product. (http://www.quitsmoking.com/aroma/suppress/index.htm).
The
Menstrual Cycle and Avoiding a Large Amount of Weight Gain
According to a study published in the Journal of Substance Abuse Treatment, weight gain in the short term is almost inevitable. The study monitored a group of twenty highly dependent women smokers. The women were given monetary incentives to abstain from smoking for seven days. The results showed that weight gain in a group of heavy smokers after seven day’s abstinence was more than three pounds, while the continuing smokers gained less than half of a pound. Furthermore, the study concluded that weight gain in the luteal phase of the menstrual cycle significantly exceeded the weight gain by abstainers in the follicular phase of menstruation.
The luteal phase means that the onset of the abstainers last menstrual cycle was more than thirteen days before they started their weeklong abstinence. The follicular phase describes women who began their abstinence no more than seven days after the onset of their last menstruation cycle. Those women in the follicular phase gained approximately 1.5 ± 2.0 pounds while those women in their luteal phase gained drastically more. These women gained about 5.3 ± 2.5 pounds. Besides for the menstrual connection, the abstainers generally weighed more than those who continued to smoke after the weeklong abstinence. Nonabstainers weight remained stable regardless of menstrual phase. The journal states that this finding suggests that the effect was not caused by peri-menstrual increases in eating or fluid retention. Therefore it is hard to argue that the weight fluctuation was caused by a particular phase in the menstrual cycle.
The study’s findings show that after only a week of smoking cessation, many smokers are already drawing near to the five-pound cutoff for acceptable weight gain specified by 75% of women. Many studies have supported the notion that many weight-conscious individuals stop their quit attempts early because of short-term weight gain, but if weight gain could be delayed until after the first few difficult days of smoking cessation, the success rate might be much higher. Also, the study concluded that women should attempt to schedule their quit attempts at a time other than their luteal phase of the menstrual cycle. These women will gain less weight, which increases the success rate of weight-conscious women (Pomerleau, Pomerleau, Namenek, and Mehringer, 1999).
|
|
Abstainers (n=7) |
Continuing
Smokers (n=13) |
Significance |
|
Subject
Characteristics |
|
|
|
|
Age
(years) |
31.7±7.2 |
29.2±6.5 |
NS |
|
Education
(years) |
13.9±1.3 |
13.8±1.2 |
NS |
|
Body
Mass Index (kg/M2) |
27.2±5.2 |
21.3±2.2 |
t(7.16)=2.89,
p<.05 |
|
Self-reported
smoking patterns |
|
|
|
|
Smoking
rate (cigarettes/day) |
21.7±6.0 |
23.3±4.8 |
NS |
|
Nicotine
dependence (FTQ score) |
7.0±1.0 |
7.8±1.5 |
NS |
|
Cotinine
concentration |
|
|
|
|
Baseline
cotinine (ng/mL) |
132.7±95.7 |
237.7±47.2 |
t(18)=
-3.32, p<
.005 |
|
Cotinine
at abstinence (ng/mL) |
7.0±9.7 |
190.4±60.4 |
-- |
|
Change
in Cotinine (% of baseline) |
-92%±13 |
-16%±33 |
t(18)=5.79,
p<
.001 |
|
Weight
change |
|
|
|
|
Weight
change (pounds) |
+3.1±2.9 |
+0.3±1.9 |
t(18)=2.69,
p<
.05 |
|
|
NS=not
significant |
FTQ=
Fagerston Tolerance Questionnaire |
|
Is
Menopause to Blame?
A question and answer site discusses menopause, smoking cessation, and weight gain. This site claims that menopause shouldn’t cause any added weight gain, provided mood swings don’t cause overeating, and puts the blame of weight gain on recently quitting the habit of smoking. (http://www.naturalland.com/wlv/wlnews/cab/qa54.htm).
Results from the
United Kingdom
A study discussed in the British Journal of General Practice relates smoking cessation and body weight. The Royal College of General Practitioners Oral Contraception Study is a 30-year-old longitudinal study of 23,000 women either using oral contraceptives or not using them. The questionnaire sent to the original cohort asked numerous questions regarding lifestyle habits. One question asked about lifetime smoking habits. The questionnaire defined a regular smoker as one who had smoked at least one cigarette a day for more than one year. With this definition, women were requested to answer whether they had ever been a regular smoker. Also, the questionnaire asked her age at starting smoking, the number of cigarettes currently smoked, and if applicable, age and daily consumption at quitting. All of the information helped the study to estimate each woman’s body mass index and her smoking status at age thirty in 1994-1995. With this information, the analysis was able to inspect changes in the weight among women of different smoking status.
The results of the study showed that stopping smoking leads to weight gain. The journal reported that the proportion of obese women increased threefold during the study. At age 30, there was a 4.6% obesity rate, while in 1994/1995 the obese rate had jumped to 14.9%. The women who stopped smoking showed the biggest rise in mean body mass index (3.37) and the largest increase in obesity (13.5%). A new trend found in the study showed that women who stopped smoking less than five years ago had a significantly higher BMI than women who stopped more than twenty years ago. This indicates that the weight gained quickly after quitting can slowly be lost using diet and exercise techniques.
Not very many people would suggest the continuation or starting of the smoking habit merely to avoid weight gain. However, it is vital to make smokers thinking of quitting aware of the possibility of weight gain if they quit. The study makes sure to mention that initiatives for weight reduction be postponed until smoking cessation has been firmly established. If a person attempts to stop smoking and use weight loss initiatives, the success chance of quitting smoking will be greatly diminished (Owen-Smith, and Hannaford, 1999).
Changes in body mass index and obesity
|
|
|
Mean
BMI |
|
%
Obese |
|
|
|
Change
in smoking since aged 30 years |
When
aged 30 |
At
1994/1995 |
Difference (95%
Cl) |
When
aged 30 |
At
1994/1995 |
Difference
(95% Cl) |
|
No
change non-smoker (n=5701) |
23.28 |
25.94 |
2.66 |
4.4 |
15.0 |
10.7 |
|
No
change Smoker
(n=1824) |
22.93 |
24.88 |
1.95 |
4.6 |
11.0 |
6.4 |
|
Started
smoking (n=91) |
23.28 |
25.13 |
1.84 |
5.5 |
14.3 |
8.8 |
|
Stopped
smoking (n=1582) |
23.13 |
26.50 |
3.37 |
5.1 |
18.6 |
13.5 |
|
All
women (n=9198) |
23.18 |
25.82 |
2.64 |
4.6 |
14.9 |
10.3 |
Avoid
the Weight Gain the Healthy Way
All of these sites claim to help restrict the ex-smoker from gaining weight by maintaining a healthy diet, exercising regularly, and making these changes before the set “quit date.” With these suggestions, the majority of the sites feel as though weight gain is avoidable and with dedication, a person can actually lose weight after quitting smoking. These treatments, with the exception of the aromatherapy, are all natural and healthy ways to keep pounds off. It is important to receive all the essential vitamins and minerals; no site suggests not eating adequately in order to lose weight. It is dangerous and unhealthy to only eat enough for survival in order to achieve a weight loss goal.
Conclusion
The treatments presented in this paper are the most represented remedies for the healthy way to escape from smoking cessation weight gain. Many smokers fear the possibility of gaining several pounds if they quit, yet continue to diminish their long-term health by inhaling nicotine and the thousands of other harmful chemicals found in cigarettes. I would rather sacrifice an inch on my waistline than suffer from lung cancer, emphysema, heart disease, or other smoking related diseases. Would you?
Disclaimer
for Internet Reports
In research on the Internet, most sources lacked the official numbers of any study they conducted and did not reference to another site where the study could be reviewed in more detail. Most sites merely stuck in statistics relating to the topic, however, the statistics were not cited as to where they originated. However, the advice seems helpful to those considering quitting smoking. The bibliography information for the scientific studies can be found on the reference page of this report.
References
Nicklaus, B., N. Tomoyasu, J. Muir, & A. Goldberg (1999). Effects of Cigarette Smoking and Its Cessation on Body Weight and Plasma Leptin Levels. Metabolism, 48 (No. 6), 804-807.
Oeser, A., J. Goffaux, W. Snead, & M. Carlson (1999). Plasma Leptin Concentrations and Lipid Profiles during Nicotine Abstinence. The American Journal of the Medical Sciences, 318 (Supplement 3), 152-155.
Owen-Smith, V., & P. Hannaford (1999). Stopping smoking and body weight in women living in the United Kingdom. British Journal Of General Practice, 49, 989-990.
Pomerleau, C., O. Pomerleau, R. Namenek, & A. Mehringer (2000). Short-term weight gain in abstaining women smokers. Journal of Substance Abuse Treatment, 18, 339-342.
Sztalryd, C., J. Hamilton, B. Horowitz, P. Johnson, & F. Kraemer (1996). Alterations of lipolysis and lipoprotein lipase in chronically nicotine-treated rats. American Journal of Physiology, 270, E215-E222.
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