Does cigarette (tobacco) cessation cause weight gain independent of changes in appetite?

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From the Guidelines

Quitting cigarettes can lead to weight gain beyond changes in appetite, with an average weight gain of 3–5 kg, due to a combination of metabolic changes, increased stress and anxiety, and improved nutrient absorption. This weight gain is not solely attributed to changes in appetite, but rather a result of the body's adjustment to the absence of nicotine 1. When you stop smoking, your metabolism slows down as nicotine is no longer increasing your metabolic rate, leading to weight gain. Additionally, nicotine withdrawal can cause increased stress and anxiety, which may trigger emotional eating or snacking behaviors.

Some key factors to consider when quitting cigarettes include:

  • Metabolic changes: Nicotine increases metabolic rate, and its absence can lead to a decrease in metabolism, resulting in weight gain 1.
  • Increased stress and anxiety: Nicotine withdrawal can cause increased stress and anxiety, leading to emotional eating or snacking behaviors.
  • Improved nutrient absorption: The body becomes more efficient at absorbing nutrients once you quit smoking, which can contribute to weight gain.
  • Replacement of habits: Some people replace the hand-to-mouth habit of smoking with eating or snacking.

It is essential to note that while weight gain is a concern, the substantial cardiovascular benefits realized from smoking cessation far outweigh the potential risks associated with weight gain 1. To manage weight gain, gradually increasing physical activity and being mindful of eating habits during the quitting process can help minimize weight gain while your body adjusts to being nicotine-free.

From the Research

Weight Gain After Quitting Cigarettes

  • Weight gain after quitting cigarettes is a common phenomenon, with most smokers experiencing a weight gain, particularly within one year, and it may persist up to 8 years after smoking cessation 2.
  • The main mechanisms to explain weight gain after smoking cessation include increased energy intake, decreased resting metabolic rate, and decreased physical activity 2, 3.
  • Besides changes in appetite, weight gain after smoking cessation is also influenced by underlying genetic factors, and it mostly occurs in the subcutaneous region of the body 3.
  • Nicotine withdrawal is also a factor that contributes to weight gain and abdominal obesity after quitting smoking 4.

Factors Contributing to Weight Gain

  • Younger ages, lower socio-economic status, and heavier smoking are predictors of higher weight gain after smoking cessation 3, 5.
  • The impact of smoking cessation on weight gain is largest for younger individuals, those with no college degree, and those in the lowest quartile of baseline BMI 5.
  • Weight gain after smoking cessation appears to be influenced by decreased resting metabolic rate, decreased physical activity, and increased lipoprotein lipase activity 3.

Health Risks and Control Strategies

  • The health benefits of smoking cessation far exceed any health risks that may result from smoking cessation-induced body weight gain 2.
  • Obesity increases various inflammatory markers, and weight gain after smoking cessation temporarily increases the risk of diabetes and reduces the benefit gained by smoking abstinence 4.
  • Pharmacological treatment with medications such as nicotine patches and varenicline is useful to suppress weight gain during smoking cessation 4, 3.
  • Supporting patients to continue smoking cessation and to gradually decrease their weight will be crucial 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Weight gain after smoking cessation.

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace, 2009

Research

Smoking cessation and weight gain.

Obesity reviews : an official journal of the International Association for the Study of Obesity, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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