Abstract
Background: Current guidelines recommend smoking cessation and weight management for secondary prevention in post-myocardial infarction (MI) patients. However, little is known about the effects of smoking cessation on weight change post-MI. Methods: We examined this question using data from a randomized, double-blind, placebo-controlled trial investigating the effect of bupropion on smoking cessation in patients immediately following a MI. Weight change was compared between 3 groups: patients who reported complete abstinence, those who reported intermittent smoking, and those who reported persistent smoking during the 12-month follow-up. Analyses were restricted to patients who attended all follow-up visits (N=179). Weight was collected by research nurses at follow-up. Abstinence was defined by self-report in the previous 7 days and a carbon monoxide level ≤10 ppm. Results: During follow-up, 92 patients were abstinent, 49 were intermittently smoking, and 38 were consistently smoking. At baseline, 68.7% of patients were male, and the mean age was 53.9 years (SD 10.0). The mean weight and BMI at baseline were 78.4 kg (SD 17.7) and 27.3 kg/m 2 (SD 5.0), respectively. Mean body weight increased in all 3 groups during follow-up ( Figure ). However, patients who remained abstinent were more likely to gain weight than those who smoked persistently (difference 3.3 kg, 95% CI 0.9, 5.6). No difference in weight change was present between persistent and intermittent smokers. Both intermittent and persistent smokers reduced their daily cigarette consumption between baseline and 12-month follow-up (mean difference −15.5, 95% CI −19.1, −11.9 and −15.8, 95% CI, −19.9, −11.7, respectively). Conclusions: Patients who remain abstinent are more likely to gain weight 12 months post-MI. Given the importance of weight management in this population, strategies to ensure long-term weight control among patients who quit smoking are needed.
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