For immediate release: August 15, 2018
Boston, MA – People who gain weight after they quit smoking may face a temporary increase in the risk of developing type 2 diabetes, with the risk directly proportional to the weight gain, according to a new study from Harvard T.H. Chan School of Public Health. But regardless of weight gain, quitters can reap significant health benefits, including lower risk of cardiovascular disease, cancer, and early death.
The study was published online August 15, 2018 in the New England Journal of Medicine.
“It’s been known that quitters may have an elevated risk of developing diabetes or worsening glucose tolerance in the first few years after quitting, and this may discourage smokers from quitting,” said Qi Sun, associate professor in the Department of Nutrition and senior author of the study. “But our study shows that it is the weight change after quitting that determines diabetes risk—so as long as quitters minimize their weight gain, their diabetes risk will not increase and, over the long run, is reduced.”
Although a number of previous studies had shown that diabetes risk may increase in the first few years after smoking cessation, it wasn’t clear what was driving the increase. In the new study, researchers looked at an average of nearly 19 years of data from 171,150 U.S. men and women enrolled in three cohorts—the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals Follow-Up Study—who filled out questionnaires about their health and lifestyle every two years. The researchers identified those who quit smoking and looked at associations between their weight gain and their risk of developing type 2 diabetes, as well as the impact of weight gain on the risk of death due to cardiovascular disease and other conditions.
Compared with current smokers, recent quitters had, on average, a 22% higher risk of developing type 2 diabetes. Their increased diabetes risk peaked 5-7 years after quitting, then gradually waned. The more weight people gained after quitting smoking, the greater their risk of type 2 diabetes. Among those who didn’t gain weight there was no increased risk. In addition, long-term smoking cessation was linked with a steady reduction in diabetes risk; among quitters who didn’t smoke for 30 years, diabetes risk dropped to that of people who had never smoked.
The study also found that, even among those who gained more than 10 kg (about 22 lbs), the risk of early death due to all causes or cardiovascular disease decreased, on average, by 50% and 67%, respectively, after quitting smoking.
“Smokers shouldn’t be deterred by potential weight gain after quitting because the short-term and long-term reduction of cardiovascular disease risk is clear,” said co-lead author Yang Hu, a doctoral student in the Departments of Nutrition and Epidemiology. “However, quitters may want to consider eating a healthful diet and engaging in physical activities to minimize weight gain to keep their diabetes risk at bay and to maximize the health benefits of quitting.”
Other Harvard Chan co-authors of the study included co-lead author Geng Zong, Gang Liu, Molin Wang, Bernard Rosner, Walter Willett, JoAnn Manson, and Frank Hu.
Funding for the study came from National Institutes of Health (NIH) research grants CA186107, CA176726, CA167552, HL034594, HL035464, and DK112940. Qi Sun was supported by NIH grants ES021372 and ES022981.
“Smoking Cessation, Weight Change, Type 2 Diabetes and Mortality,” Yang Hu, Geng Zong, Gang Liu, Molin Wang, Bernard Rosner, An Pan, Walter C. Willett, JoAnn E. Manson, Frank B. Hu, Qi Sun, NEJM, August 15, 2018, doi: 10.1056/NEJMoa1803626.
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Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.