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Cigarette Smoking, Nicotine, and Body Weight
Open accessAbstract
Smokers generally gain weight when they quit smoking; this weight gain can lessen some of the health benefits of quitting smoking. We review the effectiveness of behavioral and pharmacological approaches to mitigating weight gain in the context of quitting smoking and consider mechanisms that could potentially account for the effects of smoking and nicotine on body weight. Understanding how nicotine affects body weight may lead to novel pharmacological and behavioral interventions for obesity as well as concurrent obesity and nicotine dependence. Clinical Pharmacology & Therapeutics (2011) 90 1, 164–168. doi:10.1038/clpt.2011.105
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“Nicotine, the primary psychoactive component of tobacco, is known to cause appetite-suppressing effects leading many smokers to report reduced food intake on one hand”
From Smoking and its impact on eating behavior: A review (2026) · cites this paper as [5]
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“Nicotine, the primary addictive component in tobacco, has been identified as a potent appetite suppressant. Literature indicates that nicotine activates specific pathways in the brain that reduce hunger sensations.”
From Smoking and its impact on eating behavior: A review (2026) · cites this paper as [5]
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“However, smoking is also associated with an unhealthy distribution of body fat, particularly an increase in visceral fat, which elevates the risk of heart disease, stroke and metabolic disorders such as insulin resistance and type 2 diabetes [5].”
From Smoking and its impact on eating behavior: A review (2026) · cites this paper as [5]
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“Studies have shown that nicotine interacts with the brain's reward system and alters neurotransmitter activity, particularly dopamine and serotonin, which play key roles in hunger and satiety regulation [2, 3, 4, 5-6].”
From Smoking and its impact on eating behavior: A review (2026) · cites this paper as [5]
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“Research indicates that smokers weigh, on average, 4-5 kilograms less than non- smokers.”
From Smoking and its impact on eating behavior: A review (2026) · cites this paper as [5]
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“Weight concern, a well-established reason for smoking initiation and maintenance (21), has been widely studied among smokers and identified as a barrier to smoking cessation (22, 23).”
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Sutter, M., Nasim, A., Veldheer, S., & Cobb, C. (2016) · Journal of Eating Disorders · doi:10.1186/s40337-016-0126-y · Cited by 11
“Biologically, nicotine mediates the association between cigarette smoking and body weight by increasing the resting metabolic rate of tobacco users, while smoking behaviorally provides an alternative for eating and decreasing caloric intake, together resulting in reduced body weight among tobacco users [5].”
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“Nicotine in cigarette smoke may influence body weight by decreasing appetite, and hence calorie intake, or by raising metabolic rate or decreasing metabolic efficiency through its potential effects on central nervous system.[41] For example, a recent study shows that smoking stimulates the activity of pro-opiomelanoco…”
BackgroundFactors Associated With Weight Gain After Smoking Cessation Therapy in Japan
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“…try to quit. b Key Words: Japanese & risk factors & smoking cessation & weight gain I t is well known that smoking cessation is associated withweight gain (Aubin, Farley, Lycett, Lahmek, & Aveyard, 2012; Audrain-McGovern & Benowitz, 2011; Filozof, Fernandez Pinilla, & Fernandez-Cruz, 2004).”
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“Smokers are more likely to have cardiovascular disease, diabetes, and metabolic syndrome (46, 47), although they may have a lower BMI than nonsmokers (48).”
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“Smoking has been correlated with lower body weight in several studies [34].”
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Self-citationCotinine as a Sentinel of Canine Exposure to Tobacco Smoke
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“However, smoking can also serve as a behavioural alternative to eating, resulting in decreased food intake [38].”
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Use of Tobacco for Weight Control across Products among Young Adults in the U.S. Military
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“Nicotine facilitates modest weight maintenance by increasing metabolism and suppressing appetite, and using tobacco is a behavioral distraction from eating (Audrain-McGovern & Benowitz, 2011).”
BackgroundSignificance of nutritional status in chronic obstructive pulmonary disease: a survey
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Does everyone who quit smoking gain weight? A real-world prospective cohort study
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“(22) There have also been studies showing that being < 55 years of age and having a lower SES are significant risk factors for weight gain after smoking cessation.(25) Discrepancies across studies are likely related to differences in the length of the follow-up period.”
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“The physiological effects of nicotine on appetite and weight [4,5], delivered through e-cigarettes (which are considered safer than tobacco cigarettes [85]), could provide a tool for chronic smokers with greater BMI to achieve and maintain a healthy weight.”
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“For example, some adolescents engage in smoking and insulin withholding so as to lose weight (Audrain-McGovern & Benowitz, 2011; Fulkerson & French, 2003; Neumark-Sztainer et al., 2002; Pinhas-Hamiel et al., 2013).”
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“…suppresses appetite (Jo, Talmage, & Role, 2002) and decreases food intake (Donny, Caggiula, Weaver, Levin, & Sved, 2011; Mineur et al., 2011) through mechanisms that are not fully understood but are likely a result of both physiological and behavioral factors (Audrain-McGovern & Benowitz, 2011).”
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“On the one hand, previous studies have shown that nicotine in cigarette not only accelerates the basal metabolic rate [48], but also decreases appetite by influencing appetite regulation mechanisms in the brain [49, 50].”
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“In relation to cigarette smoking, there is also evidence of increased energy expenditure (Hofstetter et al. 1986; Audrain-McGovern and Benowitz 2011), increased thermogenesis (Lupien and Bray 1988), and an altered inflammatory profile leading to cachexia (sickness anorexia) (Chen et al.”
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“The proposed mechanisms for weight gain after quitting smoking include decreased resting metabolic rate, increased energy intake, decreased PA, and increased lipoprotein lipase activity.(22,23) We, however, further examined whether postcessation weight gain was associated with worsening diet or PA behavior by comparin…”
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Pisinger, C. H., Nielsen, H. Ø., Kuhlmann, C., & Rosthøj, S. (2017) · Journal of Obesity · doi:10.1155/2017/2504078 · Cited by 6
“also leads to suppression of appetite, and smoking per se (hand to mouth behaviour) can serve as an alternative to eating [12].”
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“Part of the crowd even chooses to relapse because of weight gain (Audrain-McGovern and Benowitz, 2011).”
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“This may be explained by nicotine’s effect on the suppression of appetite and increase of energy expenditure (Audrain-McGovern & Benowitz, 2011).”
BackgroundAnalysis Effect of Nutrition Intake on Lung Function of Active Smoker and Non Smoker
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“This appears to be not much of a surprise as smoking suppresses appetite which consequently can result in a relevant weight reduction 30 .”
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“2011), that may also affect BMI and WC by changing calorie intake, lipid metabolism, and energy balance (Audrain-McGovern and Benowitz 2011; Carreras-Torres et al.”
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Nicotine Effects, Body Weight Concerns and Smoking: A Literature Review
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“Weight gain after quitting smoking is associated with increased caloric intake that cannot be entirely explained by the reversal of nicotine’s pharmacological effects (Audrain-McGovern & Benowitz, 2011; Filozof, Fernandez Pinilla, & Fernandez-Cruz, 2004; Hudmon, Gritz, Clayton, & Nisenbaum, 1999).”
BackgroundDrug Development Strategy for Type 2 Diabetes: Targeting Positive Energy Balances
Liu, Z., & Yang, B. (2018) · Current Drug Targets · doi:10.2174/1389450120666181217111500 · Cited by 8
Amini, K., Zhaleh, H., Tahvilian, R., & Farnia, V. (2019) · Bratislava Medical Journal · doi:10.4149/bll_2019_042 · Cited by 7
Álvarez, A. G., Serra-Majem, L., Castell, C., Ribas-Barba, L., & Mendez, M. (2017) · Nutrición Hospitalaria · doi:10.20960/nh.984 · Cited by 7
“Mechanisms for a possible causal relationship between current smoking and a lower BMI may include the increased metabolic rate induced by nicotine (3,5,11), the decreased metabolic efficiency or the decreased caloric absorption (reduction of appetite) (5,28) or the lower consumption of desserts –choosing to smoke afte…”
BackgroundResultAssessment of Obesity, Presumed and Proven Causes and Prevention Strategies: A Review
Uzogara, S. G. (2016) · Advances in Obesity Weight Management & Control · doi:10.15406/aowmc.2016.05.00121 · Cited by 5
Choi, B., Dobson, M., Landsbergis, P. A., Ko, S., Yang, H., Schnall, P. L., & Baker, D. B. (2013) · Journal of Internal Medicine · doi:10.1111/joim.12173 · Cited by 9
“It is well known that cigarette smoking reduces weight [8], and smoking cessation is associated with weight gain [9, 10].”
Adiposity and cancer: systematic review and meta-analysis
Watts, E. L., Gonzalez‐Feliciano, A. G., Gunter, M. J., Chatterjee, N., & Moore, S. C. (2026) · Nature Metabolism · doi:10.1038/s42255-026-01542-8 · Cited by 25
“Smoking is the dominant risk factor for these malignancies, for example, current smokers have a more than tenfold higher risk of lung cancer compared with never-smokers 39 , and is generally associated with a lower BMI 40 , raising concerns on the potential for residual confounding 41 .”
Once-Weekly Semaglutide in Adults With Daily Cigarette Use
Hendershot, C. S., Bremmer, M. P., Paladino, M. B., Kostantinis, G., Gilmore, T. A., Sullivan, N. R., Tow, A. C., Prince, M. A., Dermody, S. S., Jordan, R., et al. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.14898 · Cited by 10
Therapeutic Potential of Glucagon-Like Peptide-1 Receptor Agonists for Smoking Cessation
Hendershot, C. S., Simmons, W. K., Jha, M. K., McKee, S. A., & Yammine, L. (2026) · Biological Psychiatry · doi:10.1016/j.biopsych.2026.04.002 · Cited by 6
Xu, L., Lin, X., Zhou, T., Liu, Y., & Ge, S. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05482-4 · Cited by 6
“This further leads to smoking-related sarcopenia [44], decreased grip strength [45], weight loss [46, 47], and lowered exercise capacity and physical activity in older adults [48].”
BackgroundPatridge, E. V., Gorakshakar, A., Molusky, M. M., Ogundijo, O., Janevski, A., Julian, C., Hu, L., Vuyisich, M., & Banavar, G. S. (2024) · Computational and Structural Biotechnology Journal · doi:10.1016/j.csbj.2024.01.018 · Cited by 9
Exposures during pregnancy and at birth are associated with the risk of offspring eating disorders
Ozsvar, J., Gissler, M., Lavebratt, C., & Nilsson, I. A. K. (2023) · International Journal of Eating Disorders · doi:10.1002/eat.24053 · Cited by 6
Pereira, D. B. D. S., & Conde, W. (2023) · American Journal of Human Biology · doi:10.1002/ajhb.23905 · Cited by 6
“That is related to nicotine withdrawal that can lead to a decrease in metabolic rate and an increase anxiety levels, among other factors (Audrain-Mcgovern & Benowitz, 2011).”
BackgroundLi, H., Zhao, J., Liang, J., & Song, X. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287027 · Cited by 10
“These factors influence the brain to alter appetite and metabolic rate [32-35].”
BackgroundRita, P., Arriaga, P., Moura, A., & Guerreiro, J. (2022) · Spanish Journal of Marketing - ESIC · doi:10.1108/sjme-11-2021-0213 · Cited by 7
Mason, T. B., Tackett, A., Kechter, A., & Leventhal, A. M. (2022) · Substance Use & Misuse · doi:10.1080/10826084.2022.2096240 · Cited by 6
Barré, T., Fontaine, H., Pol, S., Ramier, C., Beo, V. D., Protopopescu, C., Marcellin, F., Bureau, M., Bourlière, M., Dorival, C., et al. (2022) · Antioxidants · doi:10.3390/antiox11020379 · Cited by 8
“The body weight-lowering effect of tobacco smoking [91] and the weight-gaining effect of quitting tobacco [92] may also explain the opposite tendencies which former and current use had on hypertension [93].”
BackgroundSpecificity of Varenicline in Blocking Mesolimbic Circuit Activation to Natural and Drug Rewards
Goldstein, N., Carty, J. R. E., & Betley, J. N. (2021) · Neuroscience · doi:10.1016/j.neuroscience.2021.12.016 · Cited by 10
The effects of graduated driver licensing on teenage body weight
Qiu, Q., & Sung, J. (2021) · Health Economics · doi:10.1002/hec.4414 · Cited by 5
Amyx, M. M., Zeitlin, J. A., Hermann, M., Castetbon, K., Blondel, B., & Ray, C. L. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049497 · Cited by 8
Lee, Y.-H., Chang, Y.-C., Shelley, M., & Liu, C.-T. (2019) · Journal of Aging and Health · doi:10.1177/0898264319862417 · Cited by 6
“Although nicotine has been suggested for weight management (Audrain-McGovern & Benowitz, 2011), further research targeting older adults should continue to investigate whether the associations between smoking and obesity are due to poor appetite among older adults or the true effect of nicotine on…”
BackgroundHuang, L.-H., Tian, F., Fan, L.-J., He, Y.-H., Peng, D., Xie, C., Tao, L., Yuan, S., Jia, D., & Chen, W.-Q. (2018) · Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2018.1522299 · Cited by 6
“Then, a question comes to our minds: “Except these, is there any other possible pathway?” A growing body of epidemiologic and experimental evidence has indicated that smoking led to a loss of appetite with subsequent weight loss, and cessation of smoking without the help of nicotine substitutes resulted to the opposit…”
BackgroundHmad, S., Jihene, M., Harrabi, I., Ghammem, R., Belkacem, M., Mounir, S., Amimi, S., Khaoula, K., Al’Absi, M., Lando, H. A., et al. (2016) · Pan African Medical Journal · doi:10.11604/pamj.2016.24.220.7163 · Cited by 9
“Adult smokers weigh, on average, 4-5 kg less than nonsmokers and are less likely to be overweight or obese [25].”
BackgroundTranslational Research on Nicotine Dependence
Falcone, M., Lee, B., Lerman, C. E., & Blendy, J. A. (2015) · Current topics in behavioral neurosciences · doi:10.1007/7854_2015_5005 · Cited by 15
“As such, post-cessation weight gain (PCWG) is often cited as a primary reason for returning to smoking (Audrain-McGovern and Benowitz 2011; Klesges et al. 1988; Meyers et al. 1997).”
BackgroundSharafi, M., Haghjoo, E., Bagheri, P., Chijan, M. R., Baeradeh, N., Afrashteh, S., & Mouseli, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-22324-4 · Cited by 5
Sahrin, S., Banna, M. H. A., Hamiduzzaman, M., Gbordzoe, N. I., Disu, T. R., Akter, S., Mouly, H. A., Hasan, M. M., & Brazendale, K. (2024) · Brain and Behavior · doi:10.1002/brb3.70118 · Cited by 6
Furulund, E., Druckrey-Fiskaaen, K. T., Carlsen, S.-E. L., Madebo, T., Fadnes, L. T., & Lid, T. G. (2024) · BMC Nutrition · doi:10.1186/s40795-024-00880-8 · Cited by 6
“This effect may be attributed to nic-otine’s widely recognized capacity to suppress appetite, potentially prompting individuals to turn to smoking as a substitute behavior for eating [31].”
BackgroundKrotter, A., Pérez, Á. G., Diego, G. A., & García–Fernández, G. (2024) · Eating Behaviors · doi:10.1016/j.eatbeh.2024.101882 · Cited by 5
Eating Disorder Symptomatology among Young Adult Cigarette and E-Cigarette Users
Smith, C. E., Mason, T. B., Kechter, A., Monterosso, J. R., & Tackett, A. (2024) · Substance Use & Misuse · doi:10.1080/10826084.2024.2330910 · Cited by 5
“Tobacco use has long been associated with eating/weight control due to the appetite suppressant effects of nicotine (Audrain-McGovern & Benowitz, 2011; Glover et al., 2016).”
BackgroundBalmori, A., Macías, A., & de la Puente, M. P. (2022) · Current Addiction Report · doi:10.1007/s40429-022-00409-8 · Cited by 5
“Young adults who are trying to lose weight are 40% more likely to smoke cigarettes [52] [53].”
BackgroundGrebenstein, P. E., Erickson, P., Grace, M. K., & Kotz, C. M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11030481 · Cited by 5
An exploration of associations between smoking motives and behavior as a function of body mass index
Ely, A. V., Keyser, H., Spilka, N. H., Franklin, T. R., Wetherill, R. R., & Audrain-McGovern, J. E. (2021) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2021.100008 · Cited by 4
Self-citationBarré, T., Pol, S., Ramier, C., Beo, V. D., Carrat, F., Bureau, M., Bourlière, M., Dorival, C., Serfaty, L., Asselah, T., et al. (2021) · Cannabis and Cannabinoid Research · doi:10.1089/can.2021.0094 · Cited by 7
“61 As tobacco is frequently co-smoked with cannabis in Europe, 62 it is possible that the effect of cannabis on body weight which we observed was in reality related to tobacco.”
Long-Term Sequelae of Smoking and Cessation in Spontaneously Hypertensive Rats
Wu, C.-W., Yau, T., Fulgar, C. C., Mack, S. M., Revilla, A. M., Kenyon, N. J., & Pinkerton, K. E. (2019) · Toxicologic Pathology · doi:10.1177/0192623319893312 · Cited by 7
“However, results herein do not support such claims, and many other studies show variability in weight gain when quitting.(47,48) While it is known that smoking and nicotine can increase metabolic rate while decreasing appetite and reducing body weight,(49) these effects are clearly counterbalanced by the long-term neg…”
Result
Metadata
- Authors
- Audrain-McGovern, J., & Benowitz, N. L.
- Affiliations
- University of Pennsylvania (US)
- University of California, San Francisco (US)
- Corresponding author
- Audrain-McGovern, J
- ORCID
- Audrain-McGovern, J
- Venue
- Clinical Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2011-06-01
- Volume
- 90
- Issue
- 1
- Pages
- 164-168
- ISSN
- 0009-9236 (ISSN-L)
- 1532-6535
- PMC
- PMC3195407
- OpenAlex
- W2144936440
- Cited by
- 571
- References
- 46
- Citations by year
- 2026: 35 · 2025: 48 · 2024: 54 · 2023: 37 · 2022: 70 · 2021: 46 · 2020: 57 · 2019: 42 · 2018: 39 · 2017: 37 · 2016: 40 · 2015: 24 · 2014: 13 · 2013: 12 · 2012: 15
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (DA02277, R01DA002277, U01DA020830, R37DA002277)
- National Cancer Institute (P50CA143187)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Keywords
- cigarette smoking, nicotine, body weight, weight gain after quitting smoking, nicotine dependence, obesity, pharmacological interventions, behavioral interventions, smoking cessation
- MeSH terms
- Body Weight, Health Status, Humans, Nicotine, Obesity, Smoking, Weight Gain, Smoking Cessation, Nicotinic Agonists
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