When giving up smoking, most people put on weight. Many smokers are concerned about this and say it may put them off making an attempt quit. Some studies show that weight gain also leads to people resuming smoking after an initially successful quit attempt. On the other hand, there are good reasons to believe that trying to limit weight gain may reduce the chance of stopping smoking. Several drug and behavioural programmes to limit post cessation weight gain have been tested. Of the drug treatments, naltrexone showed the most promise, but there were no data on its effects on weight once drug treatment stopped and there was not enough evidence to judge its effects on long term quitting. Weight management education alone did not limit weight gain and may undermine cessation. Weight management education with personalised support giving feedback on personal goals and a personal energy prescription limited weight gain and there was no evidence that it undermined cessation. Intermittent use of a VLCD improved cessation success and weight gain in the short term but not in the longer term.
Some smoking cessation treatments also limited weight gain. Bupropion, fluoxetine, NRT and varenicline all limited weight gain during treatment, however the effects on weight gain reduction were smaller after the treatment had stopped and there was insufficient evidence to be sure that these effects persisted in the long-term. There was some evidence to suggest that exercise reduced post cessation weight gain but more studies are needed to clarify whether this was a chance finding. The effects of all interventions were modest in relation to the average weight gain that follows stopping smoking.