TIME: Almanac 1993/TIME Almanac 1993.iso/time/032591/0325130.000

Text File | 1992-08-28 | 5.8 KB | 119 lines

                                                                                HEALTH, Page 55

Why Quitting Means Gaining


Sad but true: giving up cigarette smoking means battling the
bulge, especially for women

By JANICE M. HOROWITZ -- With reporting by Lynn Emmerman/Chicago
and Joseph J. Kane/Atlanta


    Quitting cigarettes is generally something to celebrate, but
for many ex-smokers there is a weighty price to pay on the
scale. Last week a study by the Centers for Disease Control
confirmed what many former smokers have learned from
experience: people who swear off smoking can expect to gain
weight -- an average of 3.8 kg (8 lbs.) for women, 2.8 kg (6
lbs.) for men. More disturbing is the finding that 1 in 8 women
who quit -- and 1 in 10 male quitters -- add a hefty 13 kg (29
lbs.) or more, while continuing smokers tend to gain much less.
The CDC's report, published last week in the New England
Journal of Medicine, noted that certain groups are particularly
likely to lose the battle of the bulge, among them blacks,
people under 55 and those who smoked more than 15 cigarettes
a day.

    The CDC's study is not the first to link quitting with
gaining, but it represents the most comprehensive work to date.
Epidemiologist David Williamson and his research team reviewed
data on 1,885 smokers and 768 nonsmokers who were studied over
a period of 13 years. The report provides the clearest
demonstration that women gain more than men, notes Neil
Grunberg, medical psychologist at Bethesda's Uniformed Services
University, who wrote an accompanying editorial. "It's very
impressive."

    Why do people plump up after giving up cigarettes? There are
several emotional and behavioral factors, including simply the
habit of putting something into one's mouth. But experts
increasingly believe physiological factors play the largest
role. Nicotine, found in tobacco, speeds up physiological
functions, especially the rate at which the body metabolizes
food. "Though people will tell you they smoke to relax, in
reality, they're all charged up," says psychologist Daniel
Kirschenbaum of Chicago's Northwestern Memorial Hospital. A
smoker's heart rate, for instance, averages 84 beats a minute,
compared with 72 beats for a nonsmoker. When smoking stops,
metabolism slows down, food is burned more slowly and the
pounds can start piling on. Research by psychologist Richard
Keesey at the University of Wisconsin suggests the added pounds
represent a return to a more normal weight. Smoking, he says,
"artificially lowers the body weight."

    Recent quitters frequently feel an almost uncontrollable
urge to gorge on sugary, high-carbohydrate foods. This too is
probably due to the powerful influence of nicotine. In smokers,
the drug lowers the level of insulin in the bloodstream, which
in turn decreases the craving for sweet-tasting food. Grunberg
has shown in laboratory animals that removing nicotine causes
insulin levels to rise, prompting greater consumption of
sweets. This sweet-tooth effect is far more pronounced in
female animals than in males, which may explain the difference
found between the two sexes in the CDC study. But researchers
are baffled by the increased vulnerability of blacks to weight
gain. Says Williamson: "More work needs to be done."

    Health officials are concerned that the desire to stay slim
may be contributing to the high rate of smoking among teenage
girls, who tend to take up the habit at a younger age than
boys. Just this month the American Journal of Public Health
reported that more than twice as many adolescent girls as boys
said they were worried about gaining weight if they quit
smoking. In years past, cigarette companies capitalized on such
fears. Lucky Strike ads in the 1920s encouraged women to "Reach
for the Lucky Strike Instead of a Sweet." Unfortunately, doctors
note, even modest weight gains can loom large for women: a
gain of 8 lbs., for instance, can translate into a different
dress size; for men it may only mean letting the belt out a
notch or two.

    Specialists offer a host of recommendations for warding off
the weight. "Just making people aware that nicotine withdrawal
may lead to an increase in their appetite is often enough to
prevent them from putting on the pounds," says Chicago
internist Robert Gluckman, an obesity specialist. Chewing
nicotine gum to cut down the physical withdrawal from the
addiction is also often advised, as is engaging in some form
of aerobic exercise to help push up the metabolic rate. To
satisfy the craving for sweets, Grunberg suggests, quitters
should sprinkle everything, from meat to poultry to fruit, with
a sugar substitute.

    National smoking-cessation programs also provide clever
techniques to help people adjust to life without a cigarette
dangling from their mouth. Smokenders, based in Connecticut,
explains that a person puffs about 10 times for every cigarette
smoked, or 200 times a day for every pack. With this in mind,
the group teaches people to brush and floss after each meal in
order to "give mouths plenty of that attention they're
missing," says seminar director Charlotte Tausz. She also
suggests "ways of engaging in noncaloric pucker responses" like
sipping water through a straw or sucking on ginger root and
cinnamon sticks.

    Will the CDC study discourage smokers from snuffing the
habit? If so, this would be a terrible mistake, says
Kirschenbaum, who adds that the health risk of smoking a pack
and a half to two packs a day "is equal to carrying 60 to 80
extra pounds in body weight." Smoking, which leads to 400,000
U.S. deaths a year, "is about the most dangerous thing a person
can do," affirms Tausz. "I'd rather see someone be a few pounds
heavier and a nonsmoker, than smoke and be skinny." No doctor
would disagree, but try telling that to a teenage girl.