Smoking cessation and weight gain: Evidence from China

Risk of incident type 2 diabetes in male NAFLD and NAFLD-free smokers: a 7-year post-cessation study

BACKGROUND

We aimed to investigate the post-cessation T2DM risk in male NAFLD and NAFLD-free smokers in a 7-year cohort study.

METHODS

The study population was male adults who underwent annual health checkups in a 7-year cohort study. Recent quitters were categorized into four groups based on their weight gain during follow-up: < 0 kg, 0-1.9 kg, 2.0-3.9 kg, and ≥ 4.0 kg. Cox proportional hazard models, adjusted for various variables, were used to estimate hazard ratios (HRs) for the association between post-cessation weight gain and incident T2DM in NAFLD and NAFLD-free individuals.

RESULTS

At baseline, we included 1,409 NAFLD and 5150 NAFLD-free individuals. During a total of 39,259 person-years of follow-up, 222 (15.8%) NAFLD patients and 621 (12.1%) NAFLD-free participants quit smoking, with the corresponding means (standard deviations) of post-cessation weight gain being 2.24 (3.26) kg and 1.15 (3.51) kg, respectively. Among NAFLD individuals, compared to current smokers, the fully adjusted HRs (95% CI) for incident T2DM were 0.41 (0.06-3.01), 2.39 (1.21-4.70), 4.48 (2.63-7.63), and 6.42 (3.68-11.23) for quitters with weight gains < 0 kg, 0.0-1.9 kg, 2.0-3.9 kg, and ≥ 4.0 kg, respectively. For NAFLD-free individuals, we only observed a significant association between post-cessation weight gain ≥ 4.0 kg and the risk of incident T2DM (P < 0.001). Further analysis revealed that the impact of post-cessation weight gain on T2DM risk was not affected by alcohol consumption or obesity status at baseline.

CONCLUSIONS

Mild post-cessation weight gain significantly increased the risk of T2DM in male NAFLD patients but not in male NAFLD-free individuals. Therefore, it is recommended that individuals with NAFLD manage their weight after quitting smoking.

Early smoking lead to worse prognosis of COPD patients: a real world study

BACKGROUND

Smoking remains a major risk factor for the development and progression of chronic obstructive pulmonary disease (COPD). Due to the adolescent smoking associated with worse health state, the age, at which an individual started smoking, might play a key role in shaping the trajectory of COPD development and the severity.

METHODS

We conducted an observational study from September 2016 through January 2023 of eligible patients hospitalized with COPD. Patients who started smoking during the alveolar development stage (ADS, smoking initiation ≤ 24 years old) were defined as early smoking patients, and patients who started smoking after ADS (smoking initiation > 24 years old) were defined as late smoking patients. We collected demographic and clinical data characterizing the patients and documented their condition from hospital discharge to follow-up. The primary endpoints were short-term (within one year), 3-year, and long-term (beyond 3 years) all-cause mortality after discharge.

RESULTS

Among 697 COPD patients, early smoking patients had a lower smoking cessation rate (P < 0.001) and a higher smoking index (P < 0.001) than late smoking patients. Although adjusted smoking index, early smoking patients still had poorer lung function (P = 0.023), thicker left ventricular diameters (P = 0.003), higher frequency of triple therapy use during stable stage (P = 0.049), and more acute exacerbations in the past year before enrollment (P < 0.05). Survival analysis showed that they had a higher risk of death after discharge within three years (P = 0.004) and beyond three years (P < 0.001). Furthermore, even in early smoking COPD patients who quit smoking after adjusting the smoking index had poorer lung function (P < 0.05) and thicker left ventricular diameters (P = 0.003), and survival analysis also showed that they had a higher long-term mortality rate (P = 0.010) and shorter survival time (P = 0.0128).

CONCLUSION

Early smoking COPD patients exhibited multiple adverse clinical outcomes, including heavy cigarette addiction, compromised pulmonary function, augmented left ventricular diameter, and elevated mortality risk. Additional, smoking cessation could not bring enough improvement of health state in early smoking COPD patients as late smoking COPD patients. Consequently, early intervention and specialized cessation approaches for younger smokers are of paramount importance in this context.

Association Between Smoking Habits and Body Weight Among General Population in Saudi Arabia

BACKGROUND

Smoking is a significant cause of mortality and is strongly associated with the development of morbid diseases, such as obesity. There is a considerable interest in understanding the impact of smoking on body weight. The exact nature remains unclear due to the mixed results observed in the literature review. The aim of this study is to evaluate the association between smoking and body weight concerning demographic characteristics in the western region of Saudi Arabia.

METHODS

This cross-sectional study was carried out in the western region of Saudi Arabia from November 15, 2022 to July 15, 2023. To collect data, an online survey was utilized, and the survey link was shared across various social media platforms. The survey was completed by a total of 744 individuals who were at least 18 years old and answered a self-reported questionnaire on the web.

RESULTS

Analysis showed that (39%) of participants lead a sedentary lifestyle, and (58.8%) have an abnormal BMI. Among them approximately 25% are overweight, 12.4% are obese, and 7.4% are extremely obese. Moreover, a greater number of them were traditional smokers. Our study reported that individuals who had quit smoking were more likely to be overweight. Regarding self-perception of their weight, almost half of the participants consider themselves overweight and they're more likely to smoke, whether it be traditional or electronic cigarettes.

CONCLUSION

This study revealed a strong link between smoking habits and increased weight status, as measured by body mass indexes. These findings have important implications for public health interventions aimed at reducing smoking rates and obesity levels. By recognizing the potential connection between these two risk factors, experts in public health can develop more effective strategies to promote healthy behaviors and prevent chronic diseases among young individuals.