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Physical activity and weight gain after smoking cessation in postmenopausal women

Luo, Juhua PhD1; Manson, JoAnn E. MD, DrPH2; Hendryx, Michael PhD3; Shadyab, Aladdin H. PhD4; Johnson, Karen C. MD, MPH5; Dinh, Paul C. Jr. MS1; Going, Scott B. PhD6; Chlebowski, Rowan MD, PhD7; Stefanick, Marcia L. PhD8; Margolis, Karen L. MD, MPH9

doi: 10.1097/GME.0000000000001168
Original Articles

Objective: Weight gain frequently occurs after smoking cessation. The objective of this study was to examine whether weight gain after smoking cessation was attenuated by physical activity (PA) in postmenopausal women.

Methods: A total of 4,717 baseline smokers from the Women's Health Initiative were followed for 3 years. One thousand two hundred eighty-two women quit smoking, and 3,435 continued smoking. Weight was measured at baseline and at the year 3 visit. PA was assessed at both times by self-report, summarized as metabolic equivalent task-hours per week. Multiple linear regression models were used to assess the association between PA and postcessation weight gain, adjusting for potential confounding factors.

Results: Compared with continuing smokers, quitters gained an average of 3.5 kg (SD = 5.6) between the baseline and year 3 visit. Quitters with decreased PA had the highest amount of weight gain (3.88 kg, 95% CI: 3.22-4.54); quitters with increased PA (≥15 metabolic equivalent task-hours /week) had the lowest weight gain (2.55 kg, 95% CI: 1.59-3.52). Increased PA had a stronger beneficial association for postcessation weight gain for women with obesity compared to normal weight women. Quitters who had low PA at baseline and high PA at year 3 and were also enrolled in a dietary modification intervention had nonsignificant weight gain (1.88 kg, 95% CI: −0.21-3.96) compared with continuing smokers.

Conclusions: Our data demonstrate that even a modest increase in PA (equivalent to current recommendations) can attenuate weight gain after quitting smoking among postmenopausal women, especially in combination with improved diet.

1Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN

2Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

3Department of Environmental and Occupational Health, School of Public Health, Indiana University Bloomington, Bloomington, IN

4Department of Family Medicine and Public Health, University of California, San Diego, CA

5Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN

6Department of Nutritional Science, College of Agriculture and Life Sciences, Tucson, AZ

7City of Hope National Medical Center, Duarte, CA

8Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA

9HealthPartners Institute, Minneapolis, MN.

Address correspondence to: Juhua Luo, PhD, Associate Professor, Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, 1025 E. 7th Street, Bloomington, IN 47405. E-mail:

Received 4 April, 2018

Revised 24 May, 2018

Accepted 24 May, 2018

Funding/support: The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.

Financial disclosure/conflicts of interest: None reported.

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© 2019 by The North American Menopause Society.