Smokers and Postcessation Weight Gain After Acute Coronary Syndrome

Background Smoking cessation and weight management are recommended after acute coronary syndrome ( ACS ); however, little is known about the effects of smoking cessation on weight change after ACS . We aimed to assess the effect of smoking cessation after ACS on weight over a 12‐month follow‐up period. Methods and Results Data were prospectively collected from the EVITA (Evaluation of Varenicline in Smoking Cessation for Patients Post‐Acute Coronary Syndrome) trial. Weight change was compared among 3 groups of patients: those who were completely abstinent (n=70), those who smoked intermittently (n=68), and those who smoked persistently (n=34). Patients' mean baseline weight was 83.9 kg ( SD 17.7) with a mean body mass index of 28.5 ( SD 5.4). Patients smoked a mean of 37.7 years ( SD 17.7) and a mean of 21.0 cigarettes ( SD 9.0) per day prior to their ACS . Weight change varied across groups, with abstainers gaining a mean of 4.8 kg ( SD 8.6), intermittent smokers gaining a mean of 2.0 kg ( SD 8.9) and persistent smokers losing a mean of 0.7 kg ( SD 7.4). At 52 weeks, abstainers were more likely to gain weight than persistent smokers (difference in means 5.5 kg; 95% CI 2.3–8.8). This weight gain was not associated with an increase in the use of antihypertensive or antidiabetic medications. Conclusions Following an ACS , significant weight is gained by patients who quit smoking. Weight‐management interventions among smokers who quit after ACS should be a focus of investigation in future research so that the cardiovascular benefits achieved by smoking cessation are not offset by weight gain in this high‐risk population. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 00794573.