Abstract 14474: Impact of Weight Change Following Cessation of Smoking on the Incidence of Cardiovascular Disease: A 30-Year Follow-Up for a Japanese Cohort
Background: Concerns about weight gain after smoking cessation sometimes deter smokers from quitting.
Purpose: The aim of this study is to clarify the impacts of weight changes after quitting smoking on the incidence of cardiovascular disease (CVD) through a 30-year follow-up.
Methods: The Japanese atomic-bomb survivors’ cohort study provided data from 1978 through 2008, for the current report. A baseline survey of smoking status in 1978 was used to categorize subjects as smokers, quitters, or nonsmokers. Biennial health examinations provided clinical information and measured changes in weight before and after smoking cessation. All subjects were free of prevalent CVD at baseline. Morbidity and mortality from CVD, including ischemic heart disease and stroke, were identified using the International Classification of Disease (ICD) coded database (ICD 9th = 410-4, 436-8) during the period. Cox proportional hazards estimated the association between smoking status and CVD events, and tested whether weight change following cessation of smoking modified CVD risks among the quitters.
Results: Among the 6,755 eligible participants (37% men, 31% smokers and 12% quitters), 2,075 CVD events occurred. The median period of cessation among those who had quit smoking was 9.4 years (0.0 -51.9 years). The median weight change measured 4 years out from cessation was 1.5 kg (-17.1 to 15.7 kg). After adjustment for age, sex, and CVD risk factors, compared with nonsmokers, quitters had a hazard ratio (HR) for CVD of 1.16 (95% CI, 0.99 - 1.36) and smokers had an HR of 1.31 (1.15 - 1.49). These associations showed only a minimal change after further consideration of weight gain in quitters; however, quitters who lost weight had a significantly higher HR of 1.52 (1.10 - 2.10) compared with nonsmokers. Given that the association between weight loss in quitters and the risk of CVD is plausible, an explanation for the association is far from clear.
Conclusion: In this atomic-bomb survivors’ cohort, smoking cessation was associated with a lower risk of CVD events among participants. Weight gain that occurred following smoking cessation did not modify this association; in contrast, subjects who lost weight after quitting smoking appeared to have a higher risk for CVD events.
- © 2013 by American Heart Association, Inc.