Smoking cessation and weight change in relation to cardiovascular disease incidence and mortality in people with type 2 diabetes

1. Smoking cessation without weight gain in patients with type 2 diabetes was associated with a lower risk of cardiovascular disease and all-cause and cause-specific mortality.

2. Weight gain after smoking cessation lessened the reduction in risk of experiencing cardiovascular events, emphasizing the importance of bodyweight control after cessation.

Evidence Rating: 2 (Good)

Lifestyle modifications, including smoking cessation, play an important role in the prevention and management of type 2 diabetes, and related macrovascular complications. Smoking cessation, however, is often accompanied by weight gain, raising concerns surrounding poorer diabetes control. In this prospective, population-based cohort study, data from the Nurses’ Health Study and Health Professionals Follow-up Study were used to investigate the association between cardiovascular disease and all-cause mortality with weight gain and smoking cessation in 10,809 patients with type 2 diabetes. Researchers found that recent quitters (2-6 consecutive years since smoking cessation) that did not have associated weight gain within this time period had a significantly lower risk of cardiovascular disease than patients who continued to smoke (HR 0.83, 95% CI 0.70 to 0.99) as well as recent quitters with a coinciding weight gain of 0.1 kg to 5 kg (HR 0.89, 95% CI 0.65 to 1.23), or more than 5 kg (HR 0.72, 95% CI 0.61 to 0.84). The findings of this study therefore reemphasize the importance of smoking cessation in reducing the risk of developing cardiovascular disease, morbidity and mortality. However, the importance of body weight management following cessation must also be communicated to patients, as associated weight gain can attenuate the positive effects of smoking cessation.

Click to read the study in Lancet Diabetes and Endocrinology

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