Smoking and Weight

The health benefits of not smoking are clear, yet many smokers, particularly women, use smoking as a way to control their weight. Further, a fear of weight gain can be a reason to continue to not stop. About 80% of smokers who quit do gain some weight. While a minority gain a significant amount of weight, the average weight gain is less than five pounds. ¹

Regardless of weight gain, however, the American Cancer Society and several other health organizations affirm that the health benefits gained from quitting far exceed any health risks from gaining a bit of weight. And the initial weight gain that comes in the early days of quitting may not last. There is also some encouraging new research to suggest that over time, the weight of former smokers level off, becoming comparable to those who never smoked. ²

Why Weight is Gained
The reasons for weight gain following smoking cessation are both physiologic and behavioral. About one-third of the gain is due to a reduction in metabolism (about 100 kcal/day). ³ Most of the weight gain is due to an increase in food intake. Research suggests that the increase in eating may be related to symptoms of nicotine withdrawal, such as an increase in appetite and improved taste sensations, particularly for sweeter foods. Additionally, those who turn to food as a substitute for smoking are likely to increase daily caloric intake.

Should Weight Loss and Quitting Start Together?
Some health experts do not recommend trying to lose weight and quit smoking at the same time. Why? Current smokers who reduce their caloric intake may desire to smoke more, making quitting more difficult. Several recent studies, however, demonstrate that efforts can be undertaken simultaneously. For example, a 2009 review article concluded that quitting smoking and undergoing weight control at the same time increased abstinence and reduced weight gain short-term. ⁴ Starting a weight loss program first may also help to reduce the amount that is smoked. For example, a study of women who were not yet ready to quit smoking that were randomized to a behavioral weight loss program, demonstrated increased self-efficacy to stop smoking and cut down on smoking by the end of the 12-week program. ⁵

A reasonable goal while quitting smoking is not to lose weight, but to work toward minimizing or preventing weight gain. This goal can be achieved by focusing on eating healthfully and increasing physical activity. Taking this approach may also help to reduce the stress associated with nicotine withdrawal.

The Bottom Line
If you are thinking about quitting smoking but are concerned about gaining weight, keep in mind that:

• The health benefits greatly outweigh the risks of putting on a little weight;
• Most people do not gain a great deal of weight;
• Any weight that is gained can be successfully managed once smoking cessation has been achieved.

This content is reviewed regularly. Last updated December 17, 2011.

view footnotes

Other Science Library topics:

Achieving a Sustainable Weight Loss

Healthy Nutrition

¹ Surgeon General's Report 2004

² John U, Meyer C, Rumpf HJ, Schumann A, Dilling H, Hapke U. No considerable long-term weight gain after smoking cessation: evidence from a prospective study. Eur J Cancer Prev. Jun 2005;14(3):289-295.

³ Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NIH/NHLBI

⁴ Spring B, Howe D, Berendsen M, McFadden HG, Hitchcock K, Rademaker AW, Hitsman B. Behavioral intervention to promote smoking cessation and prevent weight gain: a systematic review and meta-analysis. Addiction. 2009 Sep;104(9):1472-86.

⁵ Sallit J, Ciccazzo M, Dixon Z. A cognitive-behavioral weight control program improves eating and smoking behaviors in weight-concerned female smokers. J Am Diet Assoc. 2009 Aug;109(8):1398-405.