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Smoking Cessation in Adolescents May Lead to Some Weight Gain

Question

  • 16 year old white female presents to your office for a physical.  She smokes 1/2 ppd of cigarettes and wants to quit, but is concerned about subsequent weight gain.  Does smoking cessation in adolescents result in subsequent weight gain, and if so, how much?=

Clinical Bottom Lines

  1. Though no studies to date focus on adolescents, extrapolated data from a young adult  population (ages 18-30) show a post-cessation weight gain average of 9 lbs (4.2 kg) in  whites and 14 lbs (6.6 kg) in blacks as compared to continuous smokers.1 
  2. The weight gain above was directly related to the number of cigarettes smoked per day.


Summary of Key Evidence

    Average Weight Gain (pounds)
    Smoking Status
    Blacks (n)
    Whites (n)
    Continuous
    5.9 (447)
    5.5 (297)
    Quitter
    12.5 (65)
    9.7 (91)
    Never smoker
    8.4 (970)
    6.1 (1054)
  1. Means were adjusted for gender, baseline weight, age, education, physical fitness, alcohol intake, and fat intake.
  2. Weight gain between continuous smokers and those who never smoked was not statistically significant in the white population
  3. Stregnths of the study include: Follow up through 7 years and overall good adjustment for important prognostic factors
  4. Weaknesses:  Study included very light smokers (5 cigarettes/week) as regular smokers; results did not include the average number of cigarettes smoked for each group; high attrition rate (24%) threatens validity; relied on self-reporting of smoking status; did not report the total energy intake.

Additional Comments

  • List any pertinent issues in the critical appraisal
  • List any key biological mechanisms at issue
  • List key elements of the cost or other consequences of executing the bottom line (such as side-effects or toxicity)

Citation

  1. Klesges et al.  The prospective relationship between smoking and weight in a young, biracial cohort: The coronary artery risk development in young adults study.  Journal of Consulting and Clinical Psychology, 1998; 66: 987-993.

CAT Author: Cheryl Green, MD

CAT Appraisers: John G. Frohna, MD

Date appraised: December 13, 1999

Last updated June 14, 2003
Department of Pediatrics and Communicable Diseases
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