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  • Review Article
  • Published:

Metabolic effects of smoking cessation

Nature Reviews Endocrinology volume 12, pages 299–308 (2016)Cite this article

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An Erratum to this article was published on 30 September 2016

This article has been updated

Key Points

  • In general, an inverse relationship between smoking and BMI exists

  • Post-cessation-related obesity might contribute to insulin resistance

  • The number one reason for not wanting to quit smoking or quitting and then relapsing is fear of post-cessation weight gain, especially in women and in individuals with obesity

  • Future smoking cessation programs and therapies need to be designed with an emphasis on reducing post-cessation weight gain

  • The benefits of smoking cessation outweigh the risks

Abstract

Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain.

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Figure 1: Mechanisms by which cigarette smoking reduces body weight.
Figure 2: Mechanisms by which nicotine leads to insulin resistance.
Figure 3: Prevalence of smoking and obesity.
Figure 4: Weight gain within the first year of attempting to quit smoking.
Figure 5: Changes in BMI over 10 years with smoking status.

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Change history

  • 30 September 2016

    On page 302 of the above article, VLDL in Figure 2 was incorrectly labelled as VDL. This has been corrected online.

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Acknowledgements

Salary support for T.C.F. was provided by the Diversity-promoting Institutions Drug Abuse Research Development Program (grant R24DA017298) and the National Institute on Minority Health and Health Disparities (grant U54MD007598). The authors acknowledge the professional development core of the Charles R. Drew University Accelerating Excellence in Translational Science (AXIS) (grant U54MD007598) for help with editing the manuscript.

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  1. Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, California 90059, USA.,

    Kindred K. Harris, Mohan Zopey & Theodore C. Friedman

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K.K.H., M.Z. and T.C.F. researched data for the article. K.K.H. and T.C.F. provided substantial contributions to discussions of the content. K.K.H., M.Z. and T.C.F. wrote the article and reviewed and/or edited the manuscript before submission.

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Correspondence to Theodore C. Friedman.

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Harris, K., Zopey, M. & Friedman, T. Metabolic effects of smoking cessation. Nat Rev Endocrinol 12, 299–308 (2016). https://doi.org/10.1038/nrendo.2016.32

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