Columnist Dr. Bill Andrade: Some tips about weight gain after quitting smoking

Monday, April 7, 1997 | 11:59 a.m.

ASIDE from cigarette manufacturers, no one thinks smoking is a good idea. In fact, it is the leading avoidable cause of all deaths. Let me help you put this in perspective. The numbers of Americans dying daily from cigarette smoking is roughly equal to three filled 747 jets crashing, with no survivors.

Nevada has the highest number of smokers per capita in the nation. No state suffers more from lung cancer than the Silver State.

Yet, no matter how much sense it makes, many people find it impossible to stop. Besides being physically dependent on nicotine, the quitter faces another difficult challenge: not gaining weight. Many smokers, women in particular, fear this.

Today's article discusses how to address this problem.

Does giving up cigarettes inevitably result in weight gain? In a 1990 review on studies of smoking cessation, the surgeon general's office calculated that about 80 percent of quitters do gain weight. A more recent government study of more than 5,000 adults, age 35 and older, found that giving up cigarettes was accompanied by weight gain -- an average of about 9 pounds for men and 10 pounds for women. These facts are not as easy to interpret as you think. Mainly because more than half of those who continued to smoke also gained weight.

Black people under the age of 55 who are heavy smokers are at elevated risk for major weight gain. Nicotine replacement -- in particular, nicotine gum -- appears to be effective in delaying weight gain. However, once nicotine gum use ceases, the quitting smoker gains an amount of weight that is about the same as never having used it.

Why does weight gain occur? No one knows for sure. Some researchers think cigarette smoking boosts metabolism and burns extra calories. So, when you quit, these extra calories catch up with you.

But a recent review by Kenneth Perkins of the University of Pittsburgh School of Medicine found that metabolic differences between smokers and nonsmokers are, in fact, slight. Perkins thinks that smoking produces a feeling of fullness that makes it easier for smokers not to snack. No one is sure if it's the nicotine or one of the other 4,000 chemicals in cigarette smoke that has some effect on metabolism and appetite.

How about this explanation? Maybe it's just that, when smokers quit, they put food in their mouths instead of cigarettes. Well, whatever the cause, a clearer understanding of this problem might lead to more effective ways of beating the cigarette habit.

If you dread weight gain, remember the health risks of gaining 10 pounds don't begin to approach those of continuing to smoke. It's estimated that you would have to gain 80 to 90 pounds to put the same strain on your heart as a pack-a-day habit.

Prospective quitters may find it helpful to be realistic about the possibility of gaining a few pounds. But here's the good news. Recent studies have shown the tendency to gain weight after smoking may be only temporary.

Here are three suggestions I give my patients:

* Do one thing at a time. Quitting smoking is so difficult that you probably shouldn't combine it immediately with a weight-loss program. Two studies, published in the American Journal of Public Health in 1992, cautioned against tackling both problems at once.

In one study, adding a weight-loss program to a standard smoking-cessation program seemed to increase the risk of smoking relapse. In the other study, quitters who simultaneously quit and went on a weight-loss program gained as much weight as a group who weren't trying to lose at all.

* Exercise more when you quit. Even if all you do is walk an extra mile every day, that can burn 100 calories and help offset weight gain. It may also keep your mind off cigarettes. Joining a health club will put you in a nonsmoking environment, no matter what type of exercise you choose.

* Change your snacking habits. If the desire to snack overwhelms you, try munching raw carrots or other vegetables. By adding low-fat dips, they can be almost as satisfying as potato chips or candy, and they pack more nutrients and far fewer calories.

No wonder anxiety about weight gain is an important impediment to smoking cessation.

Yet the effects of smoking are slow and invisible. On the other hand, the unwanted effects of weight gain are obvious and immediate. Self-esteem suffers and wardrobes have to be altered or even replaced. Is there a solution to all of this? Yes. The same one that works for other healthy lifestyle changes: planning, patience and resolve.