Smoking Cessation, Weight Gain, and the Trajectory of Estimated Risk of Coronary Heart Disease: 8-Year Follow-up From a Prospective Cohort Study

Abstract

Introduction The effect of weight gain following smoking cessation on cardiovascular risks is unclear. We aimed to prospectively investigate the association of weight gain following smoking cessation with the trajectory of estimated risks of coronary heart disease (CHD). Methods In a cohort of 18 562 Japanese male employees aged 30–64 years and initially free of cardiovascular diseases, participants were exclusively grouped into sustained smokers, quitters with weight gain (body weight increase ≥5%), quitters without weight gain (body weight increase <5% or weight loss), and never smokers. Global 10-year CHD risk was annually estimated by using a well-validated prediction model for the Japanese population. Linear mixed models and piecewise linear mixed models were used to compare changes in the estimated 10-year CHD risk by smoking status and weight change following smoking cessation. Results During a maximum of 8-year follow-up, both quitters with and without weight gain had a substantially decreased level of estimated 10-year CHD risk after quitting smoking, compared with sustained smokers (all ps for mean differences < .001). The estimated 10-year CHD risk within the first year after cessation decreased more rapidly in quitters without weight gain than in quitters with weight gain (change rate [95% confidence interval, CI] −0.90 [−1.04 to −0.75] vs. −0.40 [−0.60 to −0.19] % per year, p < .0001). Thereafter, the estimated 10-year CHD risk in both groups increased at similar rates (change rate [95% CI] −0.07 [−0.21 to 0.07] vs. 0.11 [−0.09 to 0.30] % per year, p = .16, from year 1 to year 2; and 0.10 [0.05 to 0.15] vs. 0.11 [0.04 to 0.18] % per year, p = .80, from year 2 to year 8). Conclusions In this population of middle-aged, Japanese male workers, smoking cessation greatly reduces the estimated 10-year risk of CHD. However, weight gain weakens the beneficial effect of quitting smoking in a temporary and limited fashion. Implications To the best of our knowledge, this study is the first to examine the effect of weight gain following smoking cessation on the trajectory of the absolute risk of CHD. Our data imply that the benefits of cessation for reducing the absolute risk of CHD outweigh the potential risk increase due to weight gain, and suggest that in order to maximize the beneficial effects of quitting smoking, interventions to control post-cessation weight gain might be warranted.

Lifetime employment, tobacco use, and alcohol consumption trajectories and cardiovascular diseases in old age

“…Our results are consistent with those of previous studies on the association between CVD and long-term experiences in the single domains of employment ( van Hedel et al, 2016 ), tobacco use ( Chen et al, 2019 ), and alcohol consumption ( Ortolá et al, 2019 ). Our findings also reveal that simultaneous experiences in these domains have different effects on the cardiovascular outcomes evaluated.…”

“…Regarding studies on the health effects of long-term tobacco use patterns, one of the key findings is that people following smoking trajectories characterized by late cessation, as well as those who stop smoking earlier in life and experience weight gain afterward, are at higher risk of CVD ( Chen et al, 2019 ; Hu et al, 2018 ; Liu et al, 2020 ; Mayyas & Alzoubi, 2018 ).…”

Effect of Smoking on Outcomes of Allogeneic Transplantation: A Single-Center Analysis

“…In allo-HCT recipients, the conditioning toxicity and allo-immune response may further increase the infiltration of lymphocytes or macrophages [26][27][28][29], which eventually might result in the development of BO or IP, although the true reasons remain to be elucidated. Smoking is also associated with coronary disease and stroke [30][31][32][33]. However, the present study did not show a significant increase in these complications, since the incidence was very low even in the whole cohort.…”

Who Are Free from Hypertension, Dyslipidemia, and Diabetes Mellitus in the Middle-Aged and Elderly Population of Japan?

“…Similar to the abovementioned alcohol intake, the results of the present study regarding smoking should be interpreted carefully. Previous studies have shown that quitting smoking reduces the risk of cardiovascular diseases such as stroke and heart disease (Chen et al 2021;Clair et al 2013;Kim et al 2018). Although these preventive effects were attenuated for those who gain weight after smoking cessation, the beneficial effects of quitting smoking remained to exist (Chen et al 2021;Liu et al 2020).…”