Download PDF
Horm Metab Res 2004; 36(3): 178-182
DOI: 10.1055/s-2004-814343
Original Clinical
© Georg Thieme Verlag Stuttgart · New York

Weight Gain and Cardiovascular Risk Factors During Smoking Cessation with Bupropion or Nicotine

J.  I.  Botella-Carretero1 , H.  F.  Escobar-Morreale1 , I.  Martín2 , A.  M.  Valero3 , F.  Alvarez1 , G.  García1 , C.  Varela1 , M.  Cantarero2
  • 1Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain
  • 2Unit of Endocrinology, Nutrition and Dietetics, Gabinete Médico Velázquez, Madrid, Spain
  • 3Unit of Pulmonology and Allergy, Gabinete Médico Velázquez, Madrid, Spain
Further Information

Publication History

Received 15 May 2003

Accepted after revision 13 October 2003

Publication Date:
01 April 2004 (online)

Also available at
    Permissions and Reprints

Abstract

Weight gain is frequent after smoking cessation, and may limit patient’s will to quit and long-term success. Nicotine and bupropion are effective drugs for smoking withdrawal. However, their influence on weight gain, insulin resistance and other cardiovascular risk factors, as well as possible differences in obese and lean subjects, have not been fully evaluated. We randomised 25 lean and 25 obese smokers to receive either bupropion or nicotine patches. Clinical evaluation and lipid profile were performed at baseline and after treatment. Insulin resistance was also assessed at the end. Weight, BMI, waist-to-hip ratio, and diastolic blood pressure increased (p < 0.005), whereas lipid profile improved (p < 0.001) after smoking cessation independently of obesity at baseline or drug used. Obese patients had higher insulin resistance at the end (p < 0.05) regardless of drug used. Weight gain was inversely related to age (β= - 0.125, R = 0.38, p = 0.046), and insulin resistance was related to obesity at baseline (β = 0.85, R = 0.46, p = 0.02). In conclusion, weight gain after smoking cessation is not dependent on obesity or drug taken. A beneficial lipid profile is achieved after quitting smoking with either bupropion or nicotine patch in both obese and lean subjects.

Key words

Insulin resistance - Obesity - Lipid profile

References

  • 1 Tonnesen P, Paoletti P, Gustavsson G, Russell M A, Saracci R, Gulsvik A, Rijcken B, Sawe U. Higher dosage nicotine patches increase one-year smoking cessation rates: results from the European CEASE trial. Collaborative European Anti-Smoking Evaluation. European Respiratory Society.  Eur Respir J. 1999;  13 238-246
    CrossrefPubMedSearch in Google Scholar
  • 2 Tonnesen P, Norregaard J, Simonsen K, Sawe U. A double-blind trial of a 16-hour transdermal nicotine patch in smoking cessation.  N Engl J Med. 1991;  325 311-315
    PubMedSearch in Google Scholar
  • 3 Hurt R D, Sachs D P, Glover E D, Offord K P, Johnston J A, Dale L C, Khayrallah M A, Schroeder D R, Glover P N, Sullivan C R, Croghan I T, Sullivan P M. A comparison of sustained-release bupropion and placebo for smoking cessation.  N Engl J Med. 1997;  337 1195-1202
    CrossrefPubMedSearch in Google Scholar
  • 4 Jorenby D E, Leischow S J, Nides M A, Rennard S I, Johnston J A, Hughes A R, Smith S S, Muramoto M L, Daughton D M, Doan K, Fiore M C, Baker T B. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation.  N Engl J Med. 1999;  340 685-691
    CrossrefPubMedSearch in Google Scholar
  • 5 Holm K J, Spencer C M. Bupropion: a review of its use in the management of smoking cessation.  Drugs. 2000;  59 1007-1024
    PubMedSearch in Google Scholar
  • 6 Flegal K M, Troiano R P, Pamuk E R, Kuczmarski R J, Campbell S M. The influence of smoking cessation on the prevalence of overweight in the United States.  N Engl J Med. 1995;  333 1165-1170
    CrossrefPubMedSearch in Google Scholar
  • 7 O’Hara P, Connett J E, Lee W W, Nides M, Murray R, Wise R. Early and late weight gain following smoking cessation in the Lung Health Study.  Am J Epidemiol. 1998;  148 821-830
    PubMedSearch in Google Scholar
  • 8 Klesges R C, Ward K D, Ray J W, Cutter G, Jacobs D R Jr, Wagenknecht L E. The prospective relationships between smoking and weight in a young, biracial cohort: the Coronary Artery Risk Development in Young Adults Study.  J Consult Clin Psychol. 1998;  66 987-993
    CrossrefPubMedSearch in Google Scholar
  • 9 Borrelli B, Spring B, Niaura R, Hitsman B, Papandonatos G. Influences of gender and weight gain on short-term relapse to smoking in a cessation trial.  J Consult Clin Psychol. 2001;  69 511-515
    CrossrefPubMedSearch in Google Scholar
  • 10 Jeffery R W, Hennrikus D J, Lando H A, Murray D M, Liu J W. Reconciling conflicting findings regarding postcessation weight concerns and success in smoking cessation.  Health Psychol. 2000;  19 242-246
    CrossrefPubMedSearch in Google Scholar
  • 11 Pomerleau C S, Zucker A N, Stewart A J. Characterizing concerns about post-cessation weight gain: results from a national survey of women smokers.  Nicotine Tob Res. 2001;  3 51-60
    PubMedSearch in Google Scholar
  • 12 Molarius A, Seidell J C, Kuulasmaa K, Dobson A J, Sans S. Smoking and relative body weight: an international perspective from the WHO MONICA Project.  J Epidemiol Community Health. 1997;  51 252-260
    CrossrefPubMedSearch in Google Scholar
  • 13 Perkins K A, Epstein L H, Marks B L, Stiller R L, Jacob R G. The effect of nicotine on energy expenditure during light physical activity.  N Engl J Med. 1989;  320 898-903
    PubMedSearch in Google Scholar
  • 14 Stamford B A, Matter S, Fell R D, Papanek P. Effects of smoking cessation on weight gain, metabolic rate, caloric consumption, and blood lipids.  Am J Clin Nutr. 1986;  43 486-494
    PubMedSearch in Google Scholar
  • 15 Hill A L, Roe D J, Taren D L, Muramoto M M, Leischow S J. Efficacy of transdermal nicotine in reducing post-cessation weight gain in a Hispanic sample.  Nicotine Tob Res. 2000;  2 247-253
    PubMedSearch in Google Scholar
  • 16 Hughes J R, Hatsukami D K. Effects of three doses of transdermal nicotine on post-cessation eating, hunger and weight.  J Subst Abuse. 1997;  9 151-159
    CrossrefPubMedSearch in Google Scholar
  • 17 Attvall S, Fowelin J, Lager I, von Schenck H, Smith U. Smoking induces insulin resistance - a potential link with the insulin resistance syndrome.  J Intern Med. 1993;  233 327-332
    PubMedSearch in Google Scholar
  • 18 Facchini F S, Hollenbeck C B, Jeppesen J, Chen Y D, Reaven G M. Insulin resistance and cigarette smoking.  Lancet. 1992;  339 1128-1130
    CrossrefPubMedSearch in Google Scholar
  • 19 Eliasson B, Taskinen M R, Smith U. Long-term use of nicotine gum is associated with hyperinsulinemia and insulin resistance.  Circulation. 1996;  94 878-881
    PubMedSearch in Google Scholar
  • 20 Eliasson B, Attvall S, Taskinen M R, Smith U. Smoking cessation improves insulin sensitivity in healthy middle-aged men.  Eur J Clin Invest. 1997;  27 450-456
    CrossrefPubMedSearch in Google Scholar
  • 21 Assali A R, Beigel Y, Schreibman R, Shafer Z, Fainaru M. Weight gain and insulin resistance during nicotine replacement therapy.  Clin Cardiol. 1999;  22 357-360
    PubMedSearch in Google Scholar
  • 22 Nilsson P, Lundgren H, Soderstrom M, Fagerstrom K O, Nilsson-E P. Effects of smoking cessation on insulin and cardiovascular risk factors - a controlled study of 4 months' duration.  J Intern Med. 1996;  240 189-194
    CrossrefPubMedSearch in Google Scholar
  • 23 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
    Search in Google Scholar
  • 24 Williamson D F, Madans J, Anda R F, Kleinman J C, Giovino G A, Byers T. Smoking cessation and severity of weight gain in a national cohort.  N Engl J Med. 1991;  324 739-745
    CrossrefPubMedSearch in Google Scholar
  • 25 Wee C C, Rigotti N A, Davis R B, Phillips R S. Relationship between smoking and weight control efforts among adults in the united states.  Arch Intern Med. 2001;  161 546-550
    CrossrefPubMedSearch in Google Scholar
  • 26 Jarry J L, Coambs R B, Polivy J, Herman C P. Weight gain after smoking cessation in women: the impact of dieting status.  Int J Eat Disord. 1998;  24 53-64
    CrossrefPubMedSearch in Google Scholar
  • 27 Dale L C, Schroeder D R, Wolter T D, Croghan I T, Hurt R D, Offord K P. Weight change after smoking cessation using variable doses of transdermal nicotine replacement.  J Gen Intern Med. 1998;  13 9-15
    CrossrefPubMedSearch in Google Scholar
  • 28 Sussman N, Ginsberg D L, Bikoff J. Effects of nefazodone on body weight: a pooled analysis of selective serotonin reuptake inhibitor- and imipramine-controlled trials.  J Clin Psyquiatry. 2001;  62 256-260
    PubMedSearch in Google Scholar
  • 29 Craig W Y, Palomaki G E, Haddow J E. Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data.  BMJ. 1989;  298 784-788
    CrossrefPubMedSearch in Google Scholar
  • 30 Targher G, Alberiche M, Zenere M B, Bonadonna R C, Muggeo M, Bonora E. Cigarette smoking and insulin resistance in patients with noninsulin-dependent diabetes mellitus.  J Clin Endocrinol Metab. 1997;  82 3619-3624
    CrossrefPubMedSearch in Google Scholar
  • 31 Lakka H M, Salonen J T, Tuomilehto J, Kaplan G A, Lakka T A. Obesity and weight gain are associated with increased incidence of hyperinsulinemia in non-diabetic men.  Horm Metab Res. 2002;  34 492-498
    Thieme ConnectPubMedSearch in Google Scholar

J. I. Botella-Carretero

Department of Endocrinology · Hospital Ramón y Cajal

Carretera de Colmenar 9,100 · Madrid 28034 · Spain

Phone: +34(91)336-8342

Fax: +34(91)336-9016

Email: jibotella@hotmail.com