What one change has prevented more than 795,000 cancer deaths in the U.S. between 1975 and 2000?
The National Cancer Institute has declared April as Cancer Control Month, so it’s a good time to remind ourselves of the obvious: tobacco avoidance saves lives. That good news about cancer deaths prevented compared to expectations based on prior statistics is due to a decline in smoking. The researchers’ calculations that quantified the cumulative impact of changes in smoking produced a bittersweet note: if all tobacco smoking had ceased, 1.7 million American lung cancer deaths that did occur during this time would have been avoided.
One obstacle: some people don’t quit because they’re afraid of gaining weight. That’s a valid concern, since modest weight gain is not unusual when someone quits smoking. However, weight gain is not universal. Reaching and maintaining a healthy weight is a key step in reducing risk of cancer. First things first, however: the multiple health benefits of getting away from tobacco outweigh the small gain that may occur, and researchers are studying what people might do to avoid or limit weight gain related to smoking cessation.
Here’s what research has uncovered so far. Please pass this along to smokers you know.
What’s behind a weight gain?
Physical and behavioral reasons can promote weight gain related to smoking cessation.
- When people quit smoking, metabolic (calorie-burning) rate drops as it returns to normal without nicotine’s rate-raising effect. The impact on metabolic rate might amount to burning about 200 calories less per day on average. Over time that can add up to gradual weight gain.
- Beyond that, people may tend to eat when they previously would have smoked, increasing calorie consumption beyond their norm. In one study, people who quit smoking increased calorie consumption an average of 227 calories per day, which researchers calculated to account for 69% of the weight gain observed at three months.
What to do?
Physical activity is a multi-purpose helper.
One analysis notes that whether or not it’s enough to prevent short-term weight gain, physical activity does seem to pay off in reduced gain at one year.
√ Two or three ten- or fifteen-minute blocks of activity should burn up enough calories to compensate for that drop in metabolic rate. Spread those blocks throughout the day in a pattern that fits your lifestyle.
√ Regular exercise can decrease emotion-based eating by reducing stress and improving mood. Usually this is demonstrated in studies of moderate aerobic activity, such as brisk walking. A study is underway to test potential help from yoga. Most forms of yoga don’t burn as many calories as the same amount of time spent in more active exercise. It certainly burns more than lying on the sofa, though, and by reducing stress, it could act through changes in eating behavior or stress-related hormones to reduce weight gain.
Re-program urges to eat
√ Smoking becomes intertwined with many activities, from deskwork to ending a meal. Instead of concentrating on what you don’t want to do (smoke), concentrate on new habits to build into those times when you used to smoke. For example, you might sit and savor a cup of tea after a meal. If coffee or tea is a trigger for you to smoke, however, switch to another drink, such as ice water, club soda or ice tea. Some people find it helpful to replace smoking with something less harmful they can put in their mouth (such as sugarless gum). Others find it helpful to try to break the “oral” habit and turn to other replacement habits.
√ Nicotine withdrawl’s effects in the brain can lead to increased cravings for foods high in sugar or fat. Some people find the urge to smoke or overeat easier to handle if they eat small amounts of food several times a day to avoid letting their blood sugar drop too low. The key is to choose balanced snacks, not just sweets or chips.
Change counter-productive thinking patterns
√ Is feeling stressed what pushes you toward either smoking or eating? Don’t expect stress to end. Set the goal of learning new ways to respond to stress. In addition to going for a walk or doing yoga, try deep breathing, listening to or playing music, praying, meditating, journaling, cuddling a pet, or calling a friend. Based on these trial runs, create a portfolio of options that work for you, and teach yourself to act when you first start to feel stressed rather than waiting until the urge to smoke or eat seems unbearable.
√ Don’t let fear of weight gain deter you from the top priority of quitting. One study found that among smokers given standard smoking-cessation counseling, those who also received counseling to reduce concerns about gaining weight were significantly more likely to succeed in quitting at a one-year follow-up than those who were given diet advice to prevent weight gain or those given smoking-cessation help with no attention to weight. The funny thing: the group given help in avoiding concern about weight gain and discouraged from dieting gained less weight than either the group that did not address weight or the group focused on avoiding weight gain.
This is only one study, but does suggest that there’s a difference between adding stress by acting out of fear and focusing on self-care in a positive way. Make quitting the priority, and use physical activity and smart eating to keep you feeling good through the process. The truth is, we just don’t know whether long-term overall health benefits are greater if you avoid or limit weight gain while you quit, or if you deal with one thing at a time. Focus on the priority to quit smoking and you know you’ll have done something really big!
If you’re not a smoker, please share this with a smoker you care about who might be ready to think about this. And consider, what big or small step can you take to protect your health today?
Quit Tips from the federal Centers for Disease Control and Prevention (CDC) offers 5 tips for those who want to quit smoking.
How To Handle Withdrawal Symptoms and Triggers When You Decide To Quit Smoking, from the National Cancer Institute, provides some great ideas for handling those tough urges.
Focus on a positive goal of adding up at least 30 minutes a day in moderate physical activity. You can track time or miles on smart phone apps or websites such as America On the Move.
If you decide you want some help to keep nutritional balance in your eating habits, or if you’re looking for help in awareness of how much food may be right for you, you can track your food choices with the Choose MyPlate SuperTracker. Just be sure this is supporting you, not distracting you from the priority of quitting tobacco.
Moolgavkar SH, et al. Impact of the Reduction in Tobacco Smoking on Lung Cancer Mortality in the U.S. over the Period 1975-2000. J Natl Cancer Inst. 2012. 104(7):541-8.
Audrain-McGovern J and NL Benowitz. Cigarette Smoking, Nicotine, and Body Weight. Clin Pharmacol Ther. 2011. 90(1): 164–168.
Stamford BA et al. Effects of smoking cessation on weight gain, metabolic rate, caloric consumption, and blood lipids. Am J Clin Nutr. 1986. 43(4):486-94.
Farley AC, et al. Interventions for preventing weight gain after smoking cessation. Cochrane Database Syst Rev. 2012 Jan 18;1:CD006219.
Bock BC, et al. Yoga as a complementary treatment for smoking cessation: rationale, study design and participant characteristics of the Quitting-in-Balance study. BMC Complement Altern Med. 2010 Apr 29;10:14.
Perkins KA, et al. Cognitive-behavioral therapy to reduce weight concerns improves smoking cessation outcome in weight-concerned women. J Consult Clin Psychol. 2001. 69(4):604-13.