scholarly journals Obesity and Cardiovascular Risk After Quitting Smoking: The Latest Evidence

2019 ◽  
Vol 14 (1) ◽  
pp. 60-61
Author(s):  
Koji Hasegawa ◽  
Maki Komiyama ◽  
Yuko Takahashi
Keyword(s):  
Smoking Cessation ◽  
Cardiovascular Risk ◽  
Weight Gain ◽  
Abdominal Obesity ◽  
Pharmacological Treatment ◽  
Inflammatory Markers ◽  
Smoking Abstinence ◽  
Nicotine Patches ◽  
Quitting Smoking ◽  
Continue Smoking

Smoking cessation is one of the most effective ways to reduce cardiovascular risk. However, weight gain and abdominal obesity generally occur after quitting smoking, as a result of nicotine withdrawal. 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. The benefits of smoking cessation may be minimised by obesity in those who have stopped smoking. Pharmacological treatment with medications such as nicotine patches and varenicline is useful to suppress weight gain during smoking cessation. Supporting patients to continue smoking cessation and to gradually decrease their weight will be crucial.

scholarly journals Review: Pharmacotherapy for smoking cessation

2018 ◽  
Vol 6 (25) ◽  
pp. 31-37
Author(s):  
Chok Limsuwat ◽  
Shigeki Saito ◽  
Karin Halvorson
Keyword(s):  
Smoking Cessation ◽  
Cardiovascular Risk ◽  
Nicotine Patch ◽  
Nicotine Gum ◽  
First Line ◽  
Nicotine Replacement ◽  
Seizure Disorders ◽  
Nicotine Patches ◽  
Increased Risk ◽  
Quitting Smoking

Smoking is associated with numerous cancers and atherosclerosis. Smoking cessationhas substantial potential in reducing morbidity and mortality worldwide. The initial steps “5 A’s”(Ask, Advise, Assess, Assist, Arrange) should be applied in all patients. Behavioral counselingand pharmacotherapy are both effective, but the combination of the two is more effective thaneither alone. The first-line pharmacotherapy includes nicotine replacement, bupropion, andvarenicline. Nicotine replacement therapy (NRT) consists of long-active formulations, such asin a patch, and short-acting formulations such as in gum, lozenge, inhaler, and nasal spray. Ascompared to placebo, NRT increases the chances of quitting smoking. Nicotine replacementtherapy does not increase cardiovascular risk and is safe in patients with cardiovasculardisease. Sustained-release bupropion is more effective than nicotine patches and can becombined with nicotine patches. Buprenorphine is generally well tolerated, except that it lowersseizure threshold and is contraindicated in patients with seizure disorders. Varenicline alsosignificantly improves the success rate of smoking cessation. The latest evidence suggeststhat varenicline is not associated with an increased risk of neuropsychiatric or cardiovascularevents. In conclusion, the use of NRT (nicotine patch + nicotine gum/lozenge/inhaler/spray),bupropion (with NRT), or varenicline is strongly recommended for smoking cessation, unlessthey are contraindicated.

scholarly journals Arterial and Cardiac Remodeling Associated With Extra Weight Gain in an Isolated Abdominal Obesity Cohort

2021 ◽  
Vol 8 ◽  
Author(s):  
Damien Mandry ◽  
Nicolas Girerd ◽  
Zohra Lamiral ◽  
Olivier Huttin ◽  
Laura Filippetti ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Weight Gain ◽  
Abdominal Obesity ◽  
Left Ventricular ◽  
Middle Aged ◽  
Cardiovascular Remodeling ◽  
Lv Remodeling ◽  
Arterial Load ◽  
Remodeling Index

Introduction: This study aims to assess the changes in cardiovascular remodeling attributable to bodyweight gain in a middle-aged abdominal obesity cohort. A remodeling worsening might explain the increase in cardiovascular risk associated with a dynamic of weight gain.Methods: Seventy-five middle-aged subjects (56 ± 5 years, 38 women) with abdominal obesity and no known cardiovascular disease underwent MRI-based examinations at baseline and at a 6.1 ± 1.2-year follow-up to monitor cardiovascular remodeling and hemodynamic variables, most notably the effective arterial elastance (Ea). Ea is a proxy of the arterial load that must be overcome during left ventricular (LV) ejection, with increased EA resulting in concentric LV remodeling.Results: Sixteen obese subjects had significant weight gain (>7%) during follow-up (WG+), whereas the 59 other individuals did not (WG–). WG+ and WG– exhibited significant differences in the baseline to follow-up evolutions of several hemodynamic parameters, notably diastolic and mean blood pressures (for mean blood pressure, WG+: +9.3 ± 10.9 mmHg vs. WG–: +1.7 ± 11.8 mmHg, p = 0.022), heart rate (WG+: +0.6 ± 9.4 min−1 vs. −8.9 ± 11.5 min−1, p = 0.003), LV concentric remodeling index (WG: +0.08 ± 0.16 g.mL−1 vs. WG−: −0.02 ± 0.13 g.mL−1, p = 0.018) and Ea (WG+: +0.20 ± 0.28 mL mmHg−1 vs. WG−: +0.01 ± 0.30 mL mmHg−1, p = 0.021). The evolution of the LV concentric remodeling index and Ea were also strongly correlated in the overall obese population (p < 0.001, R2 = 0.31).Conclusions: A weight gain dynamic is accompanied by increases in arterial load and load-related concentric LV remodeling in an isolated abdominal obesity cohort. This remodeling could have a significant impact on cardiovascular risk.

scholarly journals 4066 In Teenagers Who Smoke Cigarettes Are Nicotine Patches as Compared to Placebo Effective to Decrease the Number of Cigarettes Smoked? – A Systematic Review

2020 ◽  
Vol 4 (s1) ◽  
pp. 138-138
Author(s):  
Obumneke A Amadi
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Randomized Controlled Trials ◽  
Nicotine Patch ◽  
Controlled Trials ◽  
Smoking Abstinence ◽  
Randomized Controlled ◽  
Nicotine Patches ◽  
Continuous Abstinence

OBJECTIVES/GOALS: The aim was to examine whether nicotine patch was more effective in encouraging abstinence from cigarettes smoking compared to placebo. METHODS/STUDY POPULATION: Randomized controlled trials involving the general teenage age group smokers who were current smokers-“smoked less than 100 cigarettes over their lifetime and smoked at the time of the interview. Databases were searched for relevant studies reported in English that employed a randomized design published since 2000. Two authors extracted data and assessed quality. The primary outcomes and prioritization were continuous abstinence at 3, 6 and 12-month follow-up or more for the number of patients who responded to treatment, defined as a reduction/abstinence. Heterogeneity between studies did not preclude combined analyses of the data. RESULTS/ANTICIPATED RESULTS: 4 of 266 publications were included. Four studies reported positive effects on smoking cessation at end of treatment: (1) nicotine patches improved continuous abstinence at 6 weeks – 9 weeks months; (2) nicotine patch improved continuous abstinence at 3 to 6 months; (3) nicotine patches improved continuous abstinence 6 and 12 months; (4) nicotine patches improved continuous abstinence at 6 months – 12 and 24 months (5). All studies showed, continuous abstinence at follow up differed in percentage between groups both at 6 weeks through 24 months, with NRT (Nicotine patch) intervention groups achieving higher rates in most of the studies compared to placebo intervention group. Conclusions: NRT intervention methods seem to increase smoking abstinence in those treated for smoking cessation. Further and larger sample size studies are required to make stronger the base of evidence. DISCUSSION/SIGNIFICANCE OF IMPACT: Four randomized controlled trials investigating the effectiveness of smoking cessation interventions, for teenagers who smoke cigarettes were identified for inclusion in this review. Four of the studies reported significant effects on smoking cessation, providing evidence of effectiveness of NRT (nicotine patch), behavioral support and combinations of the two, although not all trials intervention treatments found an effect. The four studies reported important intervention effects at both the short and long follow-ups required: 6 weeks up to the 24 months, thereby, providing stronger evidence to support the effectiveness of NRT intervention on smoking cessation. All studies showed some evidence of improved smoking abstinence outcomes. The four studies had in common that the smoking cessation interventions provided a combination of intent to treat prevention, and of all the clinical trials none of them suggested a negative effect of smoking cessation treatment on substance use outcomes using NRT. However, the studies used reliable methods and reported their cases properly, but the small number of studies reviewed for the systematic review makes the conclusion about the effectiveness of these interventions uncertain. The papers visibly stated how the trials protected against bias, as indicated by the Yes (low risk). No (high risk) and U as “unclear risk.” All four studies conducted a random sequence generation of participants enrolled into the study sample.

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

2019 ◽  
Author(s):  
Sanmei Chen ◽  
Yohei Kawasaki ◽  
Huanhuan Hu ◽  
Keisuke Kuwahara ◽  
Makoto Yamamoto ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Weight Gain ◽  
Mixed Models ◽  
Absolute Risk ◽  
Change Rate ◽  
Chd Risk ◽  
Japanese Male ◽  
Quitting Smoking ◽  
Body Weight Increase

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.

scholarly journals Vliyanie tabakokureniya na zdorov'e i massu telacheloveka

2010 ◽  
Vol 7 (1) ◽  
pp. 15-19 ◽  
Author(s):  
G A Mel'nichenko ◽  
S A Butrova ◽  
A A Larina
Keyword(s):  
Physical Activity ◽  
Smoking Cessation ◽  
Premature Death ◽  
Tobacco Dependence ◽  
Smoking Abstinence ◽  
Motivational Factor ◽  
First Line ◽  
Quit Smoking ◽  
Continue Smoking

Tobacco smoking causes a lot of human deseases and is one of the main reasons of premature death. Smoking cessation is very important for the patient's health but difficult for them due to development of nicotine dependence. Tobacco dependence is a chronic disease. Smoking Cessation Clinical Practice Guideline, published in 2008, emphasize the dire health consequences of tobacco dependence, regulate the way of treating patients who want to quit smoking, recommending the use of effective treatments, including counseling and medications. Seven first-line medications (5 nicotine and 2 non-nicotine, including Varenicline) that reliably increase long-term smoking abstinence rates are now available. Smoking cessation is accompanied by a moderate weigh gain. And its a strong motivational factor to continue smoking, espcially for women. Сounseling, healthy food and physical activity are recommended for such patients.

Smoking cessation, weight gain and risk of cardiovascular disease

Heart ◽  
2021 ◽  
pp. heartjnl-2021-318972
Author(s):  
Xiaowen Wang ◽  
Jia-Yi Dong ◽  
Renzhe Cui ◽  
Isao Muraki ◽  
Kokoro Shirai ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Smoking Cessation ◽  
Weight Gain ◽  
Smoking Status ◽  
Cox Proportional Hazard ◽  
Quitting Smoking ◽  
Cox Proportional Hazard Models ◽  
Never Smokers

ObjectiveTo examine whether the relationship between smoking cessation and risk of cardiovascular disease (CVD) was modified by weight gain.MethodsA total of 69 910 participants (29 650 men and 46 260 women) aged 45–74 years were grouped into six groups by smoking status in the first and 5-year surveys: sustained smokers, recent quitters according to postcessation weight gain (no weight gain, 0.1–5.0 kg, >5.0 kg), long-term quitters and never smokers. Quitting smoking within and longer than 5 years were defined as recent and long-term quitters, respectively. We used Cox proportional hazard models to estimate the HR for incident CVD, coronary heart disease (CHD) and stroke.ResultsWe identified 4023 CVDs (889 CHDs and 3217 strokes) during a median of 14.8 years of follow-up. Compared with sustained smokers, the multivariable HR (95% CI) for CVD was 0.66 (0.52 to 0.83) for recent quitters without weight gain, 0.71 (0.55 to 0.90) for recent quitters with weight gain of 0.1–5.0 kg, 0.70 (0.44 to 1.10) for recent quitters with weight gain of >5.0 kg, 0.56 (0.49 to 0.64) for long-term quitters, and 0.60 (0.55 to 0.66) for never smokers. The analysis restricted to men showed a similar association. Prespecified analysis by age suggested that recent quitters overall had a lower HR for CVD among those aged <60 years vs ≥60 years. Similar patterns of association were observed in CHD and stroke.ConclusionsPostcessation weight gain did not attenuate the protective association between smoking cessation and risk of CVD.

Exenatide Adjunct to Nicotine Patch Facilitates Smoking Cessation and May Reduce Post-Cessation Weight Gain: a Pilot Randomized Controlled Trial

2021 ◽  
Author(s):  
Luba Yammine ◽  
Charles E Green ◽  
Thomas R Kosten ◽  
Constanza de Dios ◽  
Robert Suchting ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Body Weight ◽  
Weight Gain ◽  
Extended Release ◽  
Nicotine Patch ◽  
Withdrawal Symptoms ◽  
Secondary Outcome ◽  
Smoking Abstinence ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Abstract Introduction Approved pharmacological treatments for smoking cessation are modestly effective, underscoring the need for improved pharmacotherapies. Glucagon-like peptide-1 receptor (GLP-1R) agonists attenuate the rewarding effects of nicotine in preclinical studies. We examined the efficacy of extended-release exenatide, a GLP-1R agonist, combined with nicotine replacement therapy (NRT, patch) for smoking cessation, craving and withdrawal symptoms, with post-cessation body weight as secondary outcome. Methods Eighty-four prediabetic and/or overweight smokers were randomized (1:1) to once-weekly placebo or exenatide, 2 mg, subcutaneously. All participants received NRT (21 mg) and brief smoking cessation counseling. Seven-day point prevalence abstinence (expired CO level ≤5 ppm), craving, withdrawal and post-cessation body weight were assessed following 6 weeks of treatment. A Bayesian approach for analyzing generalized linear models yielded posterior probabilities (PP) to quantify the evidence favoring hypothesized effects of treatment on the study outcomes. Results Exenatide increased the risk for smoking abstinence compared to placebo (46.3% and 26.8%, respectively), (RR = 1.70; 95% credible interval = [0.96, 3.27]; PP = 96.5%). Exenatide reduced end-of-treatment craving in the overall sample and withdrawal among abstainers. Post-cessation body weight was 5.6 pounds lower in the exenatide group compared to placebo (PP=97.4%). Adverse events were reported in 9.5% and 2.3% of participants in the exenatide and placebo groups, respectively. Conclusions Exenatide, in combination with the NRT improved smoking abstinence, reduced craving and withdrawal symptoms, and decreased weight gain among abstainers. Findings suggest that the GLP-1R agonist strategy is worthy of further research in larger, longer duration studies. Implications Despite considerable progress in tobacco control, cigarette smoking remains the leading cause of preventable disease, disability, and death. In this pilot study, we showed that extended-release exenatide, a glucagon-like peptide-1 receptor agonist, added to the nicotine patch, improved abstinence and mitigated post-cessation body weight gain compared to patch alone. Further research is needed to confirm these initial positive results.

Smoking abstinence 1 year after acute coronary syndrome in Tunisian adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Abroug ◽  
A El Hraiech ◽  
M Ben Fredj ◽  
M Kacem ◽  
I Zemni ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Smoking Cessation ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Prevention Strategy ◽  
Therapeutic Education ◽  
Smoking Abstinence ◽  
Cessation Rate ◽  
Coronary Syndrome

Abstract Background In Tunisia, coronary heart disease(CHD) is the first cause of mortality, accounting one third (33.23%) of total deaths in 2017. Although smoking cessation is the most effective CHD prevention strategy, quitting smoking is difficult and two thirds of patients return to smoking within 1 year of their acute coronary syndrome (ACS). The present study aimed to evaluate the smoking cessation rate and to assess predictors of smoking abstinence in patients with ACS, one year after hospital discharge. Methods A prospective cohort study was conducted in the Cardiology Department and Smoking Cessation Service at University Hospital of Monastir, Tunisia from January 2015 to December 2017. During their hospitalization, all patients in the sample received individual therapeutic education including a motivational interview. The follow-up were carried out by clinic visits every two weeks. Logistic regression analysis was used to evaluate the independent predictors of smoking abstinence. The statistical analysis was conducted with SPSS software, version 21.0. A p value of &lt; 0.05 was considered statistically significant. Results A total of 288 smoking patients were included in our study. All participants were male and the mean age was 55 ± 11 years. More than half (55.4%) of patients had a high level of nicotine dependence. Successful smoking cessation rate was 35.7 % [95% confidence interval (CI): 29.4-42.5%]. Independent predictors of smoking abstinence were: therapeutic adherence (odds ratio(OR): 13.8, p &lt; 0.001), the level of nicotinic dependence (OR: 0.26, p = 0.02), the length of stay in the ICU (OR: 8.31, p = 0.001) and diabetic status (OR: 4.54, p = 0.01). Conclusions This study for smoking cessation highlights the importance to generalize our protocol for all Tunisian patient with cardiovascular risk. Key messages Smoking cessation is the most effective coronary heart disease prevention strategy. More efforts are required to improve smoking cessation in patients with cardiovascular risk.

scholarly journals Combination Lorcaserin and Nicotine Patch for Smoking Cessation Without Weight Gain

2019 ◽  
Vol 22 (9) ◽  
pp. 1627-1631 ◽  
Author(s):  
Jed E Rose ◽  
James M Davis
Keyword(s):  
Smoking Cessation ◽  
Weight Gain ◽  
Weight Change ◽  
Nicotine Patch ◽  
Strong Association ◽  
Smoking Abstinence ◽  
Clinical Trial Registration ◽  
Smoking Cessation Treatment ◽  
Quit Smoking ◽  
The Impact

Abstract Introduction This study explored the efficacy of combination lorcaserin and nicotine patch for smoking cessation treatment and prevention of postsmoking cessation weight gain. Methods We conducted a trial in which 61 adult daily smokers were asked to quit smoking using a combination of lorcaserin and nicotine patch. During the first 2 weeks of treatment prior to the quit day, participants were randomized to receive either lorcaserin (10 mg twice daily) plus nicotine patch (21 mg) or placebo plus nicotine patch (21 mg). Following this 2-week period, participants received both medications for 12 weeks. Outcomes included 4-week continuous smoking abstinence at the end of treatment (weeks 7–10 postquit attempt), weight change, ad libitum smoking, withdrawal symptoms, and ratings of cigarette reward. Results Biochemically confirmed continuous smoking abstinence from 7 to 10 weeks postquit attempt was 31.1% (90% confidence interval, 21.4%–40.8%). Participants who quit smoking showed no weight gain; in fact, mean weight change was minus 0.16 kg (SD = 3.27) over the study period. There was an unexpected but strong association (p = .006) between a decrease in sensory enjoyment of smoking and successful quit outcome on this regimen. During the prequit randomization period, lorcaserin versus placebo reduced the impact of smoking to relieve craving for cigarettes as well as the sensory enjoyment of smoking (p = .005). Adherence and tolerability to lorcaserin and nicotine patch was good. Conclusions The combination of lorcaserin and nicotine patch was well tolerated, associated with a relatively high smoking abstinence rate, and effectively prevented weight gain associated with quitting smoking. Implications This report provides an important contribution to the literature because it details evidence of a medication combination—lorcaserin and nicotine—that is effective for smoking cessation and for ameliorating weight gain associated with smoking cessation. For many smokers, postcessation weight gain is a major obstacle to quitting, and this medication combination provides a suitable treatment option for these smokers. Clinical Trial Registration NCT02906644

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