Williamson D F, Madans J, Anda R F, Kleinman J C, Giovino G A, Byers T
Division of Nutrition, Centers for Disease Control, Atlanta, GA 30333.
N Engl J Med. 1991 Mar 14;324(11):739-45. doi: 10.1056/NEJM199103143241106.
Many believe that the prospect of weight gain discourages smokers from quitting. Accurate estimates of the weight gain related to the cessation of smoking in the general population are not available, however.
We related changes in body weight to changes in smoking status in adults 25 to 74 years of age who were weighed in the First National Health and Nutrition Examination Survey (NHANES I, 1971 to 1975) and then weighed a second time in the NHANES I Epidemiologic Follow-up Study (1982 to 1984). The cohort included continuing smokers (748 men and 1137 women) and those who had quit smoking for a year or more (409 men and 359 women).
The mean weight gain attributable to the cessation of smoking, as adjusted for age, race, level of education, alcohol use, illnesses related to change in weight, base-line weight, and physical activity, was 2.8 kg in men and 3.8 kg in women. Major weight gain (greater than 13 kg) occurred in 9.8 percent of the men and 13.4 percent of the women who quit smoking. The relative risk of major weight gain in those who quit smoking (as compared with those who continued to smoke) was 8.1 (95 percent confidence interval, 4.4 to 14.9) in men and 5.8 (95 percent confidence interval, 3.7 to 9.1) in women, and it remained high regardless of the duration of cessation. For both sexes, blacks, people under the age of 55, and people who smoked 15 cigarettes or more per day were at higher risk of major weight gain after quitting smoking. Although at base line the smokers weighed less than those who had never smoked, they weighed nearly the same at follow-up.
Major weight gain is strongly related to smoking cessation, but it occurs in only a minority of those who stop smoking. Weight gain is not likely to negate the health benefits of smoking cessation, but its cosmetic effects may interfere with attempts to quit. Effective methods of weight control are therefore needed for smokers trying to quit.
许多人认为体重增加的前景会阻碍吸烟者戒烟。然而，目前尚无关于普通人群中与戒烟相关的体重增加的准确估计。
我们将25至74岁成年人的体重变化与吸烟状况变化进行关联，这些成年人在第一次全国健康和营养检查调查（NHANES I，1971年至1975年）中进行了称重，然后在NHANES I流行病学随访研究（1982年至1984年）中再次称重。该队列包括持续吸烟者（748名男性和1137名女性）以及已戒烟一年或更长时间的人（409名男性和359名女性）。
在对年龄、种族、教育程度、饮酒情况、与体重变化相关的疾病、基线体重和身体活动进行调整后，因戒烟导致的男性平均体重增加为2.8千克，女性为3.8千克。戒烟的男性中有9.8%、女性中有13.4%出现了大幅体重增加（超过13千克）。戒烟者（与持续吸烟者相比）出现大幅体重增加的相对风险在男性中为8.1（95%置信区间为4.4至14.9），在女性中为5.8（95%置信区间为3.7至9.1），并且无论戒烟时长如何，该风险都保持在高位。对于男女两性而言，黑人、55岁以下人群以及每天吸烟15支或更多的人在戒烟后出现大幅体重增加的风险更高。尽管在基线时吸烟者的体重低于从未吸烟者，但在随访时他们的体重几乎相同。
大幅体重增加与戒烟密切相关，但仅发生在少数戒烟者中。体重增加不太可能抵消戒烟对健康的益处，但其外观影响可能会干扰戒烟尝试。因此，对于试图戒烟的吸烟者，需要有效的体重控制方法。
