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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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Opposing effects of nicotine on hypothalamic arcuate nucleus POMC and NPY neurons
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“本研究以上海市成年双生子为对象,利用双生 子对内对照设计匹配了遗传等因素的混杂作用,分 析健康生活方式的数量与超重/肥胖及腹型肥胖的 关系。健康生活方式的数量与超重/肥胖及腹型肥 胖均相关,数量越多患病风险越低。 本研究发现,同时拥有多种健康生活方式与较 低的超重/肥胖及腹型肥胖患病风险有关,与多数 研究结果一致[16-18]。美国一项前瞻性研究纳入了 吸烟、饮酒、体力活动、久坐时间、快餐摄入和睡眠 时长 6 种生活方式,发现与 0~1 种健康生活方式者 相比,报告有 5~6 种健康生活方式者发生超重/肥胖 的风险降低了 36%,与本研究的效应值接近[16]。欧 洲地区的一项多中心研究利用 21 个国家老年人群 进行了回归分析,结…”
Predictors of Smoking in Older Adults and an Epigenetic Validation of Self-Report
Long, J. D., Gehlsen, M. P., Moody, J., Weeks, G., & Philibert, R. A. (2022) · Genes · doi:10.3390/genes14010025 · Cited by 1
Anthropometric status of nurses working at a private hospital in Pietermaritzburg, KwaZulu-Natal
Yegambaram, L. B., & Pillay, K. (2022) · Health SA = SA Gesondheid · doi:10.4102/hsag.v27i0.1940 · Cited by 1
“Reduced food intake with smoking could also result from cigarettes being a behavioural alternative to eating (Audrain-McGovern & Benowitz 2011).”
BackgroundEffects of Dietary Antioxidant Intake on Lung Functions in Construction Workers in Surabaya
Lorensia, A., Suryadinata, R. V., & Mahfidz, I. K. (2022) · Jurnal Kesehatan Masyarakat · doi:10.15294/kemas.v18i1.26464
Barré, T., Sogni, P., Zaegel-Faucher, O., Wittkop, L., Marcellin, F., Carrieri, P., Gervais, A., Levier, A., Rosenthal, É., Salmon-Ceron, D., et al. (2022) · AIDS Education and Prevention · doi:10.1521/aeap.2022.34.4.272 · Cited by 1
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“2016) and is associated with lower body weight (AudrainMcGovern and Benowitz 2011).”
BackgroundEswaramoorthi, V., Suhaimi, M. Z., Abdullah, M. R., Sanip, Z., Majeed, A. P. P. A., Suhaimi, M. Z., Clark, C. C. T., & Musa, R. M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19126993 · Cited by 3
“It is worth noting that most of the effects of tobacco on body weight are regulated by nicotine, which induces the consumption of calories that could interfere with the weight gain processes of smokers [54].”
BackgroundWeight control behaviors associated with early menopause among Korean women
So, E. S. (2021) · Women & Health · doi:10.1080/03630242.2021.2003499 · Cited by 2
Machado, R. C. B. R., Vargas, H. O., Zazula, R., Urbano, M. R., Verri, W. A., Jr., Rossaneis, A. C., Porcu, M., Barbosa, D. S., Reis, A. D. M. F., & Nunes, S. O. V. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100249 · Cited by 1
Effect of Tobacco Cessation on Weight in a Veteran Population
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“For the primary outcomes, paired t-tests were used to compare (1) change in weight and; (2) BMI.”
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ASSESSMENT OF SMOKING BEHAVIOR AMONG MALAY MALE SMOKERS IN KELANTAN, MALAYSIA
Bakar, R. A. (2017) · doi:10.22159/ajpcr.2017.v10i2.15335 · Cited by 1
“in food intake in response to the increase in metabolic rate [24].”
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“However, as study results show, nicotine accelerates metabolism, so a lower BMI value among smokers is justified (Audrain-McGovern and Benowitz 2011).”
BackgroundComparative Effectiveness of Smoking Cessation Medications among Schizophrenic Smokers
Wu, I.-H., Chen, H., Bordnick, P., JamesEssien, E., Johnson, M. L., Peters, R., Vadhariya, A., & Abughosh, S. (2016) · Trends Journal of Sciences Research · doi:10.1016/j.jval.2016.03.477 · Cited by 1
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Duarte, R. S., Martins, I. H., Mendes, C. P., Costa, M. A. S., Mendes, D. D. S., Romano, V. F., Gomes, S. C., Reis, A., & Neves, R. D. (2014) · Revista Brasileira de Medicina de Família e Comunidade · doi:10.5712/rbmfc9(33)708 · Cited by 1
Smoking and its impact on eating behavior: A review
Department of Oral Pathology and Microbiology, M. A. D. C. A. H., Prabhakar, M., Bottu, K., Department of Oral Pathology and Microbiology, M. A. D. C. A. H., Chaly, P. E., Department of Public Health Dentistry, M. A. D. C. A. H., S.G, R. K., Department of Public Health Dentistry, T. G. D. C. A. H., M, A., & Department of Psychiatry, M. M. C. H. A. R. I. (2026) · Bioinformation · doi:10.6026/973206300220132
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“Therefore, poor people use tobacco to suppress their desire for food, leading to malnourishment and potentially causing HNC (Audrain-McGovern and Benowitz, 2011; Bunney et al., 2018; Kanwal et al., 2019; Fatima et al., 2023), which agrees with our findings for patient smokers.”
Carrasco, D. G., López, P. J. T., Piña-D’Abreu, M., Cañellas, L. R., López‐González, Á. A., & Ramírez‐Manent, J. I. (2026) · Medical Sciences · doi:10.3390/medsci14060655
“Tobacco exposure promotes oxidative stress, endothelial injury, sympathetic activation, altered lipid metabolism, and preferential visceral fat accumulation [92,93].”
The impact of e-cigarette exposure on metabolic function: a narrative review
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“The frailty index, a widely used of quitting, particularly for aging-related outcomes such as frailty 19-22 .”
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“Previous research has also shown that smoking, nicotine exposure, appetite, and body weight are linked through complex behavioral and biological pathways (25).”
Understanding smokeless tobacco use in rural Sindh through food insecurity and livelihood stress
Gulrajani, R., & Sameen, S. (2026) · Discover Public Health · doi:10.1186/s12982-026-02658-8
“Nicotine suppresses appetite through both physiological and behavioural mechanisms, including reduced hunger signalling and distraction from eating, effects that may be particularly relevant in food-insecure settings where managing hunger is a daily concern [17, 18].”
Morimoto, A., Furuki, H., Muta, A., Sun, L.-Q., & Sonoda, N. (2026) · Frontiers of Nursing · doi:10.2478/fon-2026-0035
“20 Moreover, smoking may serve as a maladaptive coping strategy in response to psychological stress, further disrupting healthy eating behaviors.”
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“On the other hand, studies in Japan and Taiwan have reported associations between smoking and higher BMI and computed tomography-assessed obesity indices [ 17 , 31 – 33 ].”
Association between smoking dependence and intuitive eating in adults in primary care
Morvan, R., Patry, M., Gaultier, A., Jacobi, D., & Péneau, S. (2026) · Nutrition and Health · doi:10.1177/02601060261480419
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“This may be partly explained by the fact that smokers tend to increase their energy expenditure by approximately 10%, resulting in weight loss and a lower BMI [20, 50].”
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“This suggests that smoking is a substantial health problem, even though rates are relatively lower compared with global averages (3).”
Wu, E., Joki, A., Venäläinen, M. S., Suojanen, L.-U., Pietiläinen, K. H., & Ahola, A. J. (2026) · European Journal of Public Health · doi:10.1093/eurpub/ckag072
“Although nicotine acutely increases resting energy expenditure and suppresses appetite, these effects may be attenuated in individuals with obesity or long-term smoking history [25, 26].”
Smoking cessation after lower extremity revascularization in the Vascular Quality Initiative
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Semaglutide and weight loss in obese patients with and without type 2 diabetes
Gupta, H., & Verma, R. (2026) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1769_24
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“Specific single nucleotide polymorphisms (SNPs) have been associ - ated with nicotine dependence and lower BMI in smokers [29 –31 ]; however, this mechanism in SCZ patients may be influenced by additional factors.”
Obesity vs. overweight status: differential predictions to poly-substance use in young adulthood
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“The established relationship between nicotine and appetite suppression (21) may partly explain the positive association between higher weight status and nicotine/ tobacco use; both adolescents and young adults frequently report using cigarette smoking and nicotine vaping as a weight management tool…”
Framing as a mechanism to overcome the temptation of bad habits
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“Smoking has been linked to lower weight [61], while both smoking and unhealthy diets, leading to obesity, have been discussed as coping mechanisms for emotional distress [27–29].”
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“This is consistent with the common belief that cigarette smoking can aid in controlling body weight, a notion ingrained in popular culture for many years [14].”
High BMI and smoking jointly cause COPD: a Mendelian randomisation study
Mikkelsen, H., Landt, E., Marott, S. C. W., Benn, M., Nordestgaard, B. G., & Dahl, M. (2025) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2024-002825
“18 Conversely, people who have smoked for a large part of their lives due to being genetically predisposed tend to have a lower BMI maybe because of the appetite-suppressing effect of nicotine.”
The impact of smoking reduction on food demand in people with excess weight
Pérez, Á. G., Krotter, A., Verdejo‐García, A., & García–Fernández, G. (2025) · Appetite · doi:10.1016/j.appet.2025.108332
Gosadi, I. M. (2025) · Healthcare · doi:10.3390/healthcare13151817
“Additionally, some who quit smoking might be at risk of weight gain after smoking cessation [42].”
Piirtola, M., Tuovinen, E.-L., Ranjit, A., Kinnunen, T., Kaprio, J. A., & Korhonen, T. (2025) · International Journal of Obesity · doi:10.1038/s41366-025-01820-7 · Cited by 2
“First, that nicotine increases energy expenditure about 10%, especially during exercise and after eating [31].”
Ernährung bei akuter und chronischer Pankreatitis
Seitzinger, M. (2025) · Die Gastroenterologie · doi:10.1007/s11377-025-00924-w
Mestre, L. M., Zoh, R. S., Perry, C. A., Fukuyama, J., & Parker, M. A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0319560
“However, among those who smoke cigarettes, their waist It is well known that cigarette smoking [31–38] and weight status [39–53] are associated with all-cause mortality due to being two of the main risk factors of chronic diseases [35,36,38,45,46,48] and chronic inflammation [11,48].”
Merza, M., Jawhar, H. J., Ahmed, A. S., Hady, R. H., & Hwaiz, R. (2025) · Journal of Neonatal Surgery · doi:10.52783/jns.v14.2218
“Nicotine elevates the levels of harmful lipids such as total cholesterol, LDL-C, and triglycerides, while simultaneously reducing beneficial lipids like HDL-C [9].”
Teng, Y., & Ren, S.-P. (2024) · Biological Trace Element Research · doi:10.1007/s12011-024-04423-x
“Smokers often weigh less than non-smokers [69].”
Piirtola, M., Filippone, E.-L., Anu, R., Kinnunen, T., Kaprio, J. A., & Korhonen, T. (2024) · medRxiv · doi:10.1101/2024.09.26.24314418
“…average, WC increases 3.9 cm during the first post-cessation year 11 As a mechanism for this it has been suggested that nicotine increases energy expenditure about 10%, especially during exercise and after eating 29 , and thus individuals who quit smoking tend to increase their body weight 1-4 6 .”
BackgroundMethodInfluentialHaran, A., Mamatha, S., & Ashwini, S. (2024) · Chest Disease Reports · doi:10.4081/cdr.12.12472
“22 14-16 Mass load effect by obesity on the upper airway increases its collapsibility, leading to OSA.”
BackgroundHochgraf, A. K., Fosco, G. M., & Lanza, S. T. (2024) · Journal of American College Health · doi:10.1080/07448481.2024.2346354
“6,18 19–22 Although most of the research on this topic has been conducted using cross-sectional studies, one prospective study of college students in the U.S. revealed that for young women (but not men), beliefs that e-cigarettes control weight mediated the link between body esteem and e-cigarette…”
Mendelian Randomization Analysis of the Causal Effect of Cigarette Smoking on Hospital Costs
Dixon, P., Sallis, H., Munafo, M. R., Smith, G. D., & Howe, L. D. (2024) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntae089 · Cited by 5
Impact of prolonged exposure to nicotine on the haematological parameters of male Wistar rats
Ojeka, S., Bekinbo, M. T., Njoku, B., & Onwoke, E. E. (2024) · World Journal of Biology Pharmacy and Health Sciences · doi:10.30574/wjbphs.2024.17.2.0033
“Despite the weight-suppressive effects of nicotine being studied extensively, the mechanism by which nicotine acts to suppress body weight remains poorly understood [12, 13].”
BackgroundMason, T. B., Tackett, A. P., & Leventhal, A. M. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2294962 · Cited by 1
“Most studies on BMI or weight status and smoking-related motives focus on smoking to control weight and appetite, primarily due to the appetite-suppressant effects of nicotine (Audrain-McGovern & Benowitz, 2011).”
BackgroundDecίdetexto: Assessment of Weight Change after Smoking Cessation Treatment for Latino Smokers
Rieth, K. K. S., Cartujano-Barrera, F., Kamen, C. S., Arana-Chicas, E., Cai, X., Gao, S., McIntosh, S., & Cupertino, A. (2023) · Journal of Community Medicine & Public Health · doi:10.29011/2577-2228.100363
“Removing nicotine affects the central nervous system by creating reduced satiety and accelerated gastric emptying [29,30], decreased metabolic rate, and increased caloric intake due to the absence of nicotine’s appetite suppressant effect [25,26].”
BackgroundInfluentialThe effect of smoking cessation on the development of weight gain in patients
Lahoda, D. (2023) · Diabetes Obesity Metabolic Syndrome · doi:10.57105/2415-7252-2023-4-03
Moon, S., Yang, Y. S., Kimm, H., Jung, K. J., Lee, J., Jee, S. H., Lee, S., Kim, S. Y., & Nam, C. M. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20064712
Huang, Y.-L. (2023) · Journal of Education, Humanities and Social Sciences · doi:10.54097/ehss.v8i.4712
“Audrain-McGovern and Benowitz contended that smoking may cause weight loss by increasing metabolism rates and decreasing appetite [27].”
BackgroundFactors associated with meeting cancer prevention guidelines in adults.
Park, S.-H., & Strauss, S. M. (2021) · Journal of Nursing Scholarship · doi:10.1111/jnu.12714
Myogenin level tends to decrease in adult male cigarette smokers
Ihim, A. C., Manafa, P., Ekechukwu, V. T., Manafa, V. I., Chukwudi, V. N., & Ogbuowelu, S. O. (2020) · Universa Medicina · doi:10.18051/univmed.2020.v39.178-183 · Cited by 1
“(26) Smoking has been linked to promoting some genetic variants thus causing low BMI value.”
BackgroundLifestyle risk factors and comorbidities of cancer patients in a country with limited resources.
Mlačo, N., Šljivo, A., Mulać, A., Kurtović-Kozarić, A., Pašić, A., Beslija, S., Cerić, Š., & Cerić, T. (2020) · Medicinski glasnik · doi:10.17392/1199-20
“This fact is confounded by smoking since individuals who smoke are generally less active and have lower body weight than nonsmokers (26).”
BackgroundA REVIEW ON NICOTINE FOR HEALTH: INSIGHT FOR “PRO-HEALTH” NICOTINE USAGE
Pribadi, F., Santosa, R. I., & Darmanto, A. G. (2020) · International Journal of Current Pharmaceutical Research · doi:10.22159/ijcpr.2020v12i4.39081
Shankar, K., Ambroggi, F., & George, O. (2020) · bioRxiv · doi:10.1101/2020.02.04.934414
Zhao, J. J., Fan, D., Su, C., Wang, H., & Zhang, B. (2020) · doi:10.21203/rs.2.22495/v1
“For example, lower levels of androgens in male smokers have been found to increase abdominal obesity [48].”
BackgroundSupriya, K., & Chaudhary, J. (2018) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20184413 · Cited by 1
“Circulating levels of norepinephrine and epinephrine increase, and the bioavailability of dopamine is altered as well.(10) Among the neuroendocrine effects are release of arginine, vasopressin, beta-endorphin, adrenocorticotropic hormone, and cortisol.”
BackgroundRees, R., & Seyfoddin, A. (2017) · Journal of Pharmaceutical Policy and Practice · doi:10.1186/s40545-017-0109-7
“The studies all measured outcomes within the fifty-two weeks immediately post cessation which is in line with evidence suggesting the greatest weight gain usually occurs in the first year post cessation [21].”
BackgroundInfluentialDiaw, M., Ndiaye, A., Sow, A., Ba-Diop, A., Foko, R., Seck/Diop, A., Diagne/Faye, S. H., Touré, M., Samb, A., Cabral, M., et al. (2025) · Open Journal of Molecular and Integrative Physiology · doi:10.4236/ojmip.2025.151001
Ygnatios, N. T. M., Moreira, B. D. S., Vieira, Í. S. D. S., Braga, L. D. S., Lima‐Costa, M. F., & Torres, J. L. (2025) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320242911.18182023 · Cited by 1
Analysis of serum lipid profile in adult female smokers in Erbil city, Kurdistan region of Iraq
Merza, M., Hwaiz, R., Yaseen, R. T., Faraj, T., Jawad, A., Harm, Hama, A., & Hamid, M. A. (2021) · doi:10.35841/0970-938x.32.1.29-31
“Nicotine increases the amount of bad fats in the blood vessels for example Total Cholesterol (TC), LDL, and TG, it may also decreases the amount of good fat for example total lipoprotein cholesterol (HDL-C) [8].”
BackgroundPatients with common endocrine disorders
Rice, S., Sharaf, G., Kyriakakis, N., Korkontzelou, A., Katsaounou, P. A., & Tonstad, S. (2021) · European Respiratory Society eBooks · doi:10.1183/2312508x.10003220 · Cited by 2
Lower weight gain after vaping cessation than after smoking quitting
Wawryk‐Gawda, E., Zarobkiewicz, M. K., Chylińska‐Wrzos, P., & Jodłowska‐Jędrych, B. (2019) · Roczniki Państwowego Zakładu Higieny · doi:10.32394/rpzh.2019.0075
“The results of many studies confirm that smokers weigh on average 4-5 kg less than non-smokers and quitting smoking leads to evening of these discrepancies [3, 6, 28].”
BackgroundInfluentialEffects of Chronic Electronic Vapor Exposure on Body Weight, Appetite, and Metabolism
Breit, M. J. (2017) · The Research Repository @ WVU (West Virginia University) · doi:10.33915/etd.5257
“…study examining the body mass index (BMI) and mortality of over 9,000 cigarette smokers resulted in smokers exhibiting a significantly reduced BMI compared to nonsmokers, and gained weight exceeding that of non-smoker baseline levels (Audrain-McGovern and Benowitz 2011) upon smoking cessation.”
BackgroundPredictors of a Successful Outcome among Adult Smokers using Smoking Cessation Medication
Wang, X., Chen, H., Essien, E. J., Yang, M., & Abughsoh, S. (2016) · Journal of Behavioral Health · doi:10.5455/jbh.20161107025953
Taleb, Z. B. (2016) · FIU - Digital Commons (Florida International University) · doi:10.25148/etd.fidc000707
Costa, E. V., & Trovisqueira, A. M. (2016) · Psicologia Teoria e Pesquisa · doi:10.1590/0102-3772e322221
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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