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How Swedes Quit Smoking Without the Weight Gain

The influence of smoking and smokeless tobacco use on weight amongst men. Published in the Journal of Internal Medicine (Volume 255, Pages 102-107, 2004) by Brad Rodu, Birgitta Stegmayr, Salmir Nasic, Philip Cole and Kjell Asplund. (UAB TRF)

Every smoker knows that if you quit smoking, chances are you’ll gain weight. That’s one of the reasons many smokers don’t stop. Now researchers at the University of Alabama at Birmingham (UAB), along with academic colleagues in Sweden, have discovered a surprising anomaly – smokers who quit by switching to Swedish smokeless tobacco (called snus, pronounced “snoos”) put on half the weight gained by those who quit tobacco altogether. In fact, switchers gained weight at the same rate as men who never smoked.

“Given the fact that smokeless tobacco is 98 percent safer than cigarettes, this significant weight control advantage shows that smokers can achieve nearly all the health benefits of quitting without fear of a major weight problem and its related health risks,” says UAB oral pathologist Dr. Brad Rodu, lead author of the study.

The researchers note that “in developed countries, smoking and excess body weight are two of the most important risk factors for chronic diseases and premature death.” Numerous studies have documented that cigarette smoking suppresses body weight, and that quitting is commonly followed by substantial weight gain. In fact, smoking cessation is believed to be responsible for about one quarter of the increase in the number of overweight U.S. men in the 1980s. The new data shows that smokers who quit tobacco entirely had an average weight gain of 15 pounds during the study’s nine-year follow-up period.

Sweden is an ideal location for smokeless tobacco research. Men in northern Sweden have among the lowest smoking rates in the world (11%), but very high rates of snus use (27%). In fact, snus appears to have played a prominent role in the region’s high smoking cessation rate, according to other research recently published by these investigators. Snus is a blend of tobacco, water, salt and flavoring that is sold in mini-teabag-like paper pouches. Swedes hide a pouch under their upper lip, discretely satisfying their nicotine craving.

Among the nearly 3,000 men at the start of the new study, the rate of overweight was 32% among those who didn’t use tobacco, 29% among smokers, and 42% for ex-smokers.

In the follow-up period, non-tobacco users had a mean weight gain of 0.4% per year, while continuing smokers and smokers who switched to snus showed statistically insignificant differences. However, smokers who quit tobacco experienced the highest weight gain of all groups: 1% per year. (Snus users who quit tobacco gained 0.7%.)

This study was supported in part by the Tobacco Research Fund (UAB). This study was also supported by grants from the Swedish Medical Research Council, the Swedish Research Council, the Research Council for Social Sciences, the Heart and Chest Fund, King Gustaf V’s and Queen Victoria’s Foundation, Vasterbotten and Norrbotten County Councils and the Swedish Public Health Institute.

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