Impact of weight change after quitting cigarettes on all-cause and cause-specific mortality in middle-aged male smokers: national health screening cohort study
Kyuwoong Kim 1  
,   Seulggie Choi 2,   Mi Hee Cho 3,   Ji Hye Jun 4,   Jooyoung Chang 5,   Sung Min Kim 2,   Kiheon Lee 4,   Sang Min Park 3
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Seoul National University, Korea, Republic of
Seoul National University, Department of Biomedical Sciences, Korea, Republic of
Seoul National University Hospital, Department of Family Medicine, Korea, Republic of
Seoul National University Bundang Hospital, Department of Family Medicine, Korea, Republic of
Seoul National University, College of Medicine, Korea, Republic of
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A342
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We aimed to investigate the association between weight change after smoking cessation and the risk of all-cause and cause-specific mortality among middle-aged male smokers.

We conducted a prospective cohort study using the National Health Insurance Service National Health Screening Cohort (NHIS-HealS) database. Male Participants (n=102,403) without critical conditions aged between 40 and 79 at baseline who underwent biennial health examination were included in this study. Participants were categorized into continued smokers, recent quitters (within 4 years), long-term quitters (more than 4 years), and never-smokers based on the self-reported smoking status. Weight change was determined by the change of Body Mass Index (BMI) between the first (2002-2003) and second (2004-2005) health examination records. We followed patients from January 1, 2006 to December, 31, 2013. To assess the risk of all-cause, cancer, cardiovascular disease (CVD) mortality, and non-cancer, non-CVD mortality according to smoking cessation and weight change, we computed Hazard Ratio (HR) and 95% Confidence Interval
(95% CI) using Cox proportional hazard models.

Severity of weight gain was more prevalent among recent quitters compared to long-term quitters. After adjusting for covariates and weight change, both recent quitters (HR:0.74; 95% CI: 0.63-0.87) and long-term quitters (HR:0.53; 95% CI:0.45-0.61) had decreased risk of all-cause mortality compared to continued smokers. Similarly, both recent and long-term quitters had decreased risk of cancer, CVD, non-cancer, and non-CVD death regardless of weight change following smoking cessation. Compared to continued smokers, non-smokers also had a lower risk of overall and cause-specific death.

Post-cessation weight change did not modify the protective association of smoking cessation with reduced risk of all-cause and cause-specific death. From a public health perspective, smoking cessation program may contribute to reducing risk of death in middle-aged male smokers despite the concern on weight change after quitting smoking.