- Prescribing Advice for GPs - https://www.prescriber.org.uk -

Smoking cessation and weight gain

The Cochrane Library has published a review of interventions that aim to prevent weight gain following smoking cessation.

According to the review, most people who stop smoking gain weight, on average about 7kg in the long term. The review examined data for pharmacological and behavioural interventions.

Pharmacological interventions including treatment with fluoxetine produced significant weight loss at the end of treatment but these effects were not found to persist at 6 or 12 months.

Of the behavioural interventions assessed only very low calorie diets and cognitive behavioural therapy (CBT) were associated with improved abstinence and reduced weight gain at end of treatment and at long-term follow up. Exercise interventions had no effect during treatment but if continued these were found to have an effect at 12 months.

Overall the authors conclude that, "the data are not sufficient to make strong clinical recommendations for effective programmes". The plain language summary indicates that drug therapies are not a long term solution. Behavioural interventions that are individualised are most successful but lack long term evidence.

Action: The risk of weight gain may pose a barrier to smoking cessation and continued abstinence for many people. Clinicians should be aware of these barriers and provide tailored lifestyle advice if this would encourage smoking cessation.