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Evidence summaries

Smoking Cessation Medication for Preventing Weight Gain after Cessation

Therapy with nicotine replacement, bupropion, or varenicline appears to have some effect for preventing weight gain after smoking cessation, but not at 12 months compared with placebo. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 83 trials. Nicotine replacement therapy (NRT) resulted in attenuation of post-cessation weight gain (MD −0.52 kg, 95% CI −0.99 to −0.05; 21 studies, n=2784; I² = 81%) and there was a trend favouring NRT at 12 months (MD −0.37 kg, 95% CI −0.86 to 0.11; 17 studies, n=1463; I² = 0%). With varenicline, weight change was very modestly lower at the end of treatment (MD −0.23 kg, 95% CI −0.53 to 0.06; 14 studies, n=2566; I² = 32%); but higher at 12 months (MD 1.05 kg, 95% CI −0.58 to 2.69; 3 studies, n=237; I² = 0%). Both bupropion and fluoxetine limited weight gain at end of treatment, but there was no evidence of benefit at 12 months.

    References

    • Hartmann-Boyce J, Theodoulou A, Farley A et al. Interventions for preventing weight gain after smoking cessation. Cochrane Database Syst Rev 2021;(10):CD006219. [PubMed]

Primary/Secondary Keywords