The Link between Tobacco Smoking, Weight Gain, and Obesity

Introduction:

Cigarettes are known to comprise more than at least 4,000 different chemicals inclusive of 70 oncogenic or cancer-causing compounds in humans. A typical nicotine cigarette comprises approximately 0.00529 ounces of nicotine. As this is a psychoactive molecule that can reach the brain in about 10 to 20 seconds after inhalation of smoke, one is likely to approximately absorb 10 percent of the nicotine contained per cigarette, eventually into the systemic circulation.

According to global statistics regarding obesity, almost 650 million adults across the world who smoke are considered to be obese (defined as individuals having a body mass index/ BMI greater than ≥30 kg/m2).

In terms of the life expectancy of individuals who are both tobacco smokers and obese (as opposed to normal-weight tobacco smokers), when compared to non-smokers, their life expectancy may be reduced by almost 13 years. This leads one to establish the direct link between tobacco smoking and obesity and this creates comorbidities in individuals, posing significant public health risks.

Can Smoking Cause Food Cravings or Need for a High-Calorie Diet?

While it may be commonly recognized through medical research that cigarette smoking is indeed an appetite suppressant for the individual, the effects of smoking upon an individual's appetite remain elusive. Some medical research exists as per documented case studies that compare the appetites of smokers to nonsmokers. While smokers may be consuming a higher intake of dietary energy, the total number of saturated fats that are unhealthy, or more prone to binge eating or consumption of energy-rich foods, the non-smoking population reportedly have fewer hunger cravings or specific cravings for saturated or high fats or refined foods for instance in comparison. It is also interesting to know that many smokers who are usually obese tend to have a much-reduced perception of dietary fat- for instance on the proportion of fats they consume dietarily and also the number of sugars consumed daily compared to non-smokers or normal-weight smokers. Many individuals would be further frustrated with the outcome of weight gain post-cessation of smoking as well, which may prompt some individuals to switch back to their regular routine of cigarette or nicotine smoking. Research currently shows that the cessation of smoking is associated with an increased intake of calories that is, nicotine consumption is directly proportional to an individual's craving for high-calorie dietary intake or foods.

What Is the Link Between Smoking, Insulin Sensitivity, and Obesity?

Current medical research also focuses and sheds light on the role of nicotine in causing functional impairment and a possible loss of the β-cells of the pancreas. As obesity is one of the first symptoms leading up to type 2 diabetes onset, it is not surprising that smokers in comparison to nonsmokers would eventually face the lifestyle complication or disorder of type 2 diabetes. These individuals may gain weight over time and show more insulin resistance, increase in the fasting plasma glucose and documented cases of obese smokers also show a decreased insulin sensitivity function.

Though smokers can be motivated by physicians to quit the habit completely, even after smoking cessation, weight gain is still a possibility. This is because as per neurologic research, nicotine is known to activate the reward centers in the neurocognitive pathways during smoking and individuals may opt to focus more on food consumption as a result of quitting smoking and this can again lead to a chain of weight gain and obesity. Hence, the professional health-care provider or physician should not only motivate the patient or the smoker to create the habit but also follow healthy lifestyle measures through diet, exercise, and pharmacologic intervention to control and sustain a healthy weight even after quitting smoking.

What Is the Counselling and Pharmacologic Intervention for Weight Reduction After Cessation of Smoking?

Counseling after cessation of smoking includes-

• Cessation of smoking is associated with improved insulin sensitivity and also a decreased risk of mortality or smoking-related pulmonary disease onset. It is important to note that as per current research, chronic or long-term nicotine smoking is one of the major risk factors for individuals regardless of age and gender to be predisposed to oral or lip cancers. Smoking cessation is also typically recommended by the dietician or nutritionist regardless of the individual's baseline weight. Current guidelines in nutrition science hence primarily emphasize not only smoking cessation but also implementing healthy measures to achieve or sustain a healthy weight or body mass index. Current interventions as per nutrition science suggest positive balanced and diet-oriented lifestyle changes along with active pharmacotherapy during smoking cessation.

• Tobacco dependence counseling is usually an effective measure along with at least one FDA (Food and Drug Administration) approved medication to sustain the individual's healthy weight. In individuals with medical conditions, however, the physician may contraindicate these medications to sustain weight. First-line tobacco cessation pharmacotherapies are mainly nicotine replacement therapies that comprise a nicotinic acetylcholine receptor partial agonist such as Varenicline drug as well as a Norepinephrine and Dopamine reuptake inhibitor/nicotinic acetylcholine receptor antagonist such as Bupropion drug.

• Bariatric surgery is also considered to be an efficacious method for the treatment of obesity post-smoking cessation. Bariatric surgery can be associated with several benefits such as improvement in obesity-related comorbidities for instance type 2 diabetes, hyperlipidemia, hypertension, and many more. This can hence reduce the risk of comorbid conditions and lifestyle diseases or the overall risk of mortality.

• Cigarette smoking would also be deemed a predictor as well as a precursor for poor post-surgical outcomes or causing postoperative surgical complications. Post-operative infections, prolonged intubation, and pneumonia can be possibilities if the patient still continues to smoke frequently or infrequently. Hence, bariatric surgery practices usually recommend complete guidance for smoking cessation before operation /procedure implementation.

Conclusion:

Current research exclusively focuses on the mediating effects and the rewarding and reinforcing actions of tobacco on the central nervous system. Nicotine may play a crucial role not only in causing systemic diseases or in the predisposition of smokers to pre cancers and cancers, but according to nutrition experts, the detrimental effects of cigarette smoking also is now directly linked to weight gain. Tobacco smoking and obesity is a current topic amongst leading nutrition experts in the world and is deemed a major cause of morbidity and mortality worldwide with an estimated global 1.1 billion tobacco smokers. Of these, those who are 15 years of age or older are more prone.