Tobacco Smoking, Eating Behaviors, and Body Weight: a Review
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Purpose of Review
This narrative review provides an overview of the relationships among tobacco smoking, eating behaviors, and body weight. The aims are to (1) examine the concurrent and longitudinal associations between tobacco smoking and body weight, (2) describe potential mechanisms underlying the relationships between smoking and body weight, with a focus on mechanisms related to eating behaviors and appetite, and (3) discuss management of concomitant tobacco smoking and obesity.
Adolescents who smoke tobacco tend to have body mass indexes (BMI) the same as or higher than nonsmokers. However, adult tobacco smokers tend to have lower BMIs and unhealthier diets relative to nonsmokers. Smoking cessation is associated with a mean body weight gain of 4.67 kg after 12 months of abstinence, though there is substantial variability. An emerging literature suggests that metabolic factors known to regulate food intake (e.g., ghrelin, leptin) may also play an important role in smoking-related behaviors. While the neural mechanisms underlying tobacco smoking-induced weight gain remain unclear, brain imaging studies indicate that smoking and eating cues overlap in several brain regions associated with learning, memory, motivation, and reward. Behavioral and pharmacological treatments have shown short-term effects in limiting post-cessation weight gain; however, their longer-term efficacy is limited.
Further studies are needed to identify the exact mechanisms underlying smoking, eating behaviors, and body weight. Moreover, effective treatment options are needed to prevent long-term weight gain during smoking abstinence.
KeywordsCigarettes Obesity Nicotine Relapse Smoking cessation Reward
Dr. Chao was supported, in part, by the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR017209. Dr. Schmidt is supported by grants from the National Institutes of Health (R01 DA037897 and R21 DA039393) and a grant from NovoNordisk.
Compliance with Ethical Standards
Conflict of Interest
Dr. Chao reports grants from National Institute of Nursing Research, personal fees from WW International, Inc., and grants and personal fees from Shire Pharmaceutical, outside the submitted work. Dr. Wadden reports grants and personal fees from Novo Nordisk, grants from Eisai Pharmaceuticals, and personal fees from Weight Watchers, outside the submitted work. Dr. Ashare reports grants from National Institute on Drug Abuse, during the preparation of this paper and grants from Novo Nordisk, Inc., outside the submitted work. Dr. Loughead reports grants from National Institute on Drug Abuse, outside the submitted work. Dr. Schmidt reports grants from National Institute on Drug Abuse, during the conduct of the study and grants from Novo Nordisk, Inc., outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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