Tian Jing, Gall Seana L, Smith Kylie J, Dwyer Terry, Venn Alison J
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
The George Institute for Global Health, University of Oxford, Oxford, UK.
Nicotine Tob Res. 2017 Mar 1;19(3):357-366. doi: 10.1093/ntr/ntw196.
The relationship between smoking cessation and weight gain is well established but the underlying mechanisms remain poorly understood. We aimed to determine whether postcessation weight gain was mediated by changing health behaviors.
A total of 281 smokers self-reported their demographic, smoking, and lifestyle characteristics in 2004-2006 (aged 26-36) and 2009-2011 (aged 31-41). Behaviors considered as potential mediators of weight gain were changes in consumption of breakfast, discretionary foods (servings/d), fruit and vegetables (servings/d), alcohol (g/d), takeaway food (times/wk), Diet Guideline Index score, leisure time physical activity (PA, min/wk), total PA (min/wk), time spent sitting (min/d), and TV viewing (h/d).
In total, 124 smokers quit smoking during 5 years follow-up. After adjustment for age, sex, baseline body mass index, education, and follow-up length, smoking cessation was associated with average excess weight gain of 2.09kg (95% CI = 0.35-3.83). Compared with continuing smokers, quitters reported a higher Diet Guideline Index score and less consumption of alcohol at baseline and follow-up (all p < .05). In addition, there was a tendency towards healthier dietary and PA behaviors over 5 years among quitters than continuing smokers except for time spent sitting, although these differences did not reach statistical significance. Adjustment for changes in these behaviors made little difference to the magnitude of postcessation weight gain (β: 2.32kg, 95% CI = 0.54-4.10).
The weight gain associated with smoking cessation was not explained by worsening dietary and PA behaviors. Future research is needed to elucidate the complex mechanisms and particularly ways it may be prevented.
Fear of weight gain often discourages smokers from trying to quit but guidance on ways to most effectively avoid weight gain is lacking. It is important to identify what causes postcessation weight gain and the ways it may be prevented. The current study explored the effects of several changing dietary and PA behaviors on the relationship between smoking cessation and weight gain in 281 young Australian smokers. We found that quitters tended to adopt healthier dietary and PA behaviors than continuing smokers, so these behaviors did not readily explain the postcessation weight gain. Further investigations of other potential mechanisms are needed.
戒烟与体重增加之间的关系已得到充分证实，但其潜在机制仍知之甚少。我们旨在确定戒烟后体重增加是否由健康行为的改变所介导。
共有281名吸烟者在2004 - 2006年（年龄26 - 36岁）和2009 - 2011年（年龄31 - 41岁）自我报告了他们的人口统计学、吸烟及生活方式特征。被视为体重增加潜在介导因素的行为包括早餐摄入量、随意性食物（份/天）、水果和蔬菜（份/天）、酒精摄入量（克/天）、外卖食品食用次数（次/周）、饮食指南指数得分、休闲时间身体活动量（PA，分钟/周）、总身体活动量（分钟/周）、久坐时间（分钟/天）以及看电视时间（小时/天）。
在5年随访期间，共有124名吸烟者戒烟。在对年龄、性别、基线体重指数、教育程度和随访时长进行调整后，戒烟与平均超重2.09千克相关（95%置信区间 = 0.35 - 3.83）。与继续吸烟者相比，戒烟者在基线和随访时报告的饮食指南指数得分更高，酒精摄入量更少（所有p < 0.05）。此外，除了久坐时间外，戒烟者在5年中比继续吸烟者更倾向于采取更健康的饮食和身体活动行为，尽管这些差异未达到统计学显著性。对这些行为变化进行调整后，戒烟后体重增加的幅度变化不大（β：2.32千克，95%置信区间 = 0.54 - 4.10）。
与戒烟相关的体重增加并非由饮食和身体活动行为恶化所导致。未来需要开展研究以阐明其中的复杂机制，尤其是预防体重增加的方法。
对体重增加的恐惧常常阻碍吸烟者尝试戒烟，但目前缺乏关于最有效避免体重增加方法的指导。确定戒烟后体重增加的原因及其预防方法很重要。本研究探讨了几种饮食和身体活动行为变化对281名澳大利亚年轻吸烟者戒烟与体重增加关系的影响。我们发现，与继续吸烟者相比，戒烟者倾向于采取更健康的饮食和身体活动行为，因此这些行为并不能轻易解释戒烟后的体重增加。需要对其他潜在机制进行进一步研究。
